Provider Demographics
NPI:1134471097
Name:CARRIKER, PATTI S (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:S
Last Name:CARRIKER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8001
Mailing Address - Country:US
Mailing Address - Phone:478-333-6363
Mailing Address - Fax:478-333-6076
Practice Address - Street 1:114 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8001
Practice Address - Country:US
Practice Address - Phone:478-333-6363
Practice Address - Fax:478-333-6076
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT002296174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist