Provider Demographics
NPI:1316925480
Name:DREYER, CARRIE LYNN (PT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:DREYER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:LYNN
Other - Last Name:PUFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PSC 819 BOX 18-205
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09645
Mailing Address - Country:US
Mailing Address - Phone:349-5682
Mailing Address - Fax:
Practice Address - Street 1:PSC 819 BOX 18-205
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09645
Practice Address - Country:US
Practice Address - Phone:349-5682
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist