Provider Demographics
NPI:1215320155
Name:MCGREGORY, CARLA H (LPTA)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:H
Last Name:MCGREGORY
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 KELLER LN
Mailing Address - Street 2:
Mailing Address - City:TUSCUMBIA
Mailing Address - State:AL
Mailing Address - Zip Code:35674-1110
Mailing Address - Country:US
Mailing Address - Phone:256-383-1535
Mailing Address - Fax:256-383-2471
Practice Address - Street 1:813 KELLER LN
Practice Address - Street 2:
Practice Address - City:TUSCUMBIA
Practice Address - State:AL
Practice Address - Zip Code:35674-1110
Practice Address - Country:US
Practice Address - Phone:256-383-1535
Practice Address - Fax:256-383-2471
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL395225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant