Individual
JAZMON MONIQUE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3437 CAROLINE ST, SAINT LOUIS, MO 63104-1111
(314) 977-2570
Mailing address
1404 S YALE DR, O FALLON, IL 62269-2738
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT-8045
ID
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
02/20/2019
Last updated
07/27/2022
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