Individual
CARRIE BOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6140 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 642-0700
(803) 642-0588
Mailing address
6140 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 642-0700
(803) 642-0588
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1437
SC
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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