Provider Demographics
NPI:1316131543
Name:CARPENTER, KARYN ELLEN (PT)
Entity type:Individual
Prefix:MISS
First Name:KARYN
Middle Name:ELLEN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 ROSEMAR RD STE 1
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-7609
Mailing Address - Country:US
Mailing Address - Phone:304-693-2781
Mailing Address - Fax:
Practice Address - Street 1:611 2ND ST STE A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750
Practice Address - Country:US
Practice Address - Phone:740-568-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant