Individual
MRS. CARRIE LYNE M MATHIESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
070.020366
IL
208100000X
Physical Medicine & Rehabilitation Physician
PTL.0012475
CO
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/30/2013
Last updated
11/13/2024
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