Provider Demographics
NPI:1093794919
Name:MAIOLFI, CAROL CHRISTINE III (PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:CHRISTINE
Last Name:MAIOLFI
Suffix:III
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4872 CANDLEBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-3058
Mailing Address - Country:US
Mailing Address - Phone:562-225-5633
Mailing Address - Fax:562-596-6901
Practice Address - Street 1:4872 CANDLEBERRY AVE
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-3058
Practice Address - Country:US
Practice Address - Phone:562-225-5633
Practice Address - Fax:562-596-6901
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist