Individual
MR. MICHAEL KEVIN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, ATC
Contact information
Practice address
9401 FOUNTAIN MEDICAL CT, BONITA SPRINGS, FL 34135-4612
(239) 494-4241
Mailing address
28227 JENEVA WAY, BONITA SPRINGS, FL 34135-8514
(239) 498-5170
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 20119
FL
Other
Enumeration date
08/09/2006
Last updated
11/01/2007
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