Individual
MRS. JEAN MARIE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
7511 FOXWOOD DR, SCHERERVILLE, IN 46375-3359
(219) 864-5924
(219) 864-5924
Mailing address
7511 FOXWOOD DR, SCHERERVILLE, IN 46375-3359
(219) 864-5924
(219) 864-5924
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
05002793A
IN
2251P0200X
Pediatric Physical Therapist
Primary
05002793A
IN
Other
Enumeration date
12/06/2008
Last updated
12/06/2008
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