Provider Demographics
NPI:1285270371
Name:LINN, CARRIE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:LINN
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 COUNTY ROAD 1290
Mailing Address - Street 2:
Mailing Address - City:VERDEN
Mailing Address - State:OK
Mailing Address - Zip Code:73092-8301
Mailing Address - Country:US
Mailing Address - Phone:405-426-9218
Mailing Address - Fax:
Practice Address - Street 1:180 COUNTY ROAD 1290
Practice Address - Street 2:
Practice Address - City:VERDEN
Practice Address - State:OK
Practice Address - Zip Code:73092-8301
Practice Address - Country:US
Practice Address - Phone:405-426-9218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-23
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1572225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist