Provider Demographics
NPI:1699713289
Name:CARR PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:CARR PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:864-232-4908
Mailing Address - Street 1:1003 GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605
Mailing Address - Country:US
Mailing Address - Phone:864-232-4908
Mailing Address - Fax:864-232-4728
Practice Address - Street 1:1003 GROVE ROAD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605
Practice Address - Country:US
Practice Address - Phone:864-232-4908
Practice Address - Fax:864-232-4728
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARR PHYSICAL THERAPY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7663Medicare PIN