Provider Demographics
NPI:1972862639
Name:RHODES, CARRIE
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 ORANGE ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-4028
Mailing Address - Country:US
Mailing Address - Phone:508-221-0228
Mailing Address - Fax:508-796-6262
Practice Address - Street 1:125 ORANGE ST
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-4028
Practice Address - Country:US
Practice Address - Phone:508-221-0228
Practice Address - Fax:508-796-6262
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist