Individual
BRETT TIMOTHY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3310 FALL HILL AVE, FREDERICKSBURG, VA 22401-3000
(540) 479-4769
Mailing address
3310 FALL HILL AVE, FREDERICKSBURG, VA 22401-3000
(540) 479-4769
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604838
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204145631
TAX ID
VA
Enumeration date
08/29/2017
Last updated
07/21/2022
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