Provider Demographics
NPI:1417690413
Name:CARR, WILLIAM (PT, DPT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:CARR
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4082 CREST VIEW RD NE
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:IA
Mailing Address - Zip Code:52333-9430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4869 S BRADLEY RD STE 114
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5088
Practice Address - Country:US
Practice Address - Phone:805-938-5320
Practice Address - Fax:805-938-5390
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.026471225100000X
CAPT305000225100000X
IA111933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist