Provider Demographics
NPI:1073633814
Name:CHOATE, CARRIE LYNN (MPT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:CHOATE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 MEADOWS PKWY
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2227
Mailing Address - Country:US
Mailing Address - Phone:636-851-6000
Mailing Address - Fax:
Practice Address - Street 1:4810 MEADOWS PKWY
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-2227
Practice Address - Country:US
Practice Address - Phone:636-851-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007008451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist