Individual
EMMA CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 17TH AVE, VERO BEACH, FL 32960-3641
(772) 562-6877
Mailing address
1705 17TH AVE, VERO BEACH, FL 32960-3641
(772) 562-6877
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PTA 25858
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25858
—
FL
Enumeration date
09/18/2015
Last updated
09/18/2015
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