Individual
CARRIE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
981 EULAINE CIR, HAMMOND, WI 54015-5033
(651) 295-8285
Mailing address
981 EULAINE CIR, HAMMOND, WI 54015-5033
(651) 295-8285
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A629
MN
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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