Individual
TIMOTHY CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
RR 2 BOX 534, COMANCHE, OK 73529-9677
(580) 467-8915
Mailing address
RR 2 BOX 534, COMANCHE, OK 73529-9677
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1114
OK
Other
Enumeration date
03/24/2007
Last updated
07/08/2007
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