Individual
MRS. AMANDA RAE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
102 CAMPUS AVE, LEWISTON, ME 04240
(207) 777-4219
(207) 777-8571
Mailing address
PO BOX 1052, GRAY, ME 04039-1052
(207) 333-7710
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3049
ME
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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