Provider Demographics
NPI:1902048564
Name:EMERSON, CAROL (PT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:EMERSON
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:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVERHILL
Mailing Address - State:NH
Mailing Address - Zip Code:03774-0082
Mailing Address - Country:US
Mailing Address - Phone:603-787-2543
Mailing Address - Fax:
Practice Address - Street 1:293 HAVERHILL LN
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-4353
Practice Address - Country:US
Practice Address - Phone:603-787-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-29
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1810225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist