Provider Demographics
NPI:1063390037
Name:HERRING, CAROLINE (PTA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:HERRING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 MILL SPRING DR APT 306
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-4545
Mailing Address - Country:US
Mailing Address - Phone:843-632-0082
Mailing Address - Fax:
Practice Address - Street 1:601 SUTTON RD S
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-8439
Practice Address - Country:US
Practice Address - Phone:803-909-6447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5018225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant