Provider Demographics
NPI:1235260373
Name:CALHOUN, CARRIE L (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 WHITE FARM RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-3132
Mailing Address - Country:US
Mailing Address - Phone:269-312-6493
Mailing Address - Fax:
Practice Address - Street 1:76 WHITE FARM RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-3132
Practice Address - Country:US
Practice Address - Phone:269-312-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer