Provider Demographics
NPI:1093185969
Name:HOURIGAN, CARRIE (CPHT, LMT, PTA)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:
Last Name:HOURIGAN
Suffix:
Gender:F
Credentials:CPHT, LMT, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 WILDWOOD LNDG
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7535
Mailing Address - Country:US
Mailing Address - Phone:843-718-4001
Mailing Address - Fax:
Practice Address - Street 1:4216 WILDWOOD LNDG
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7535
Practice Address - Country:US
Practice Address - Phone:843-718-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-04
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183700000X
SC3790225200000X
SC9742225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No183700000XPharmacy Service ProvidersPharmacy Technician
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant