Provider Demographics
NPI:1235762352
Name:CARUOLO, HEATHER PEARSON (DPT)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:PEARSON
Last Name:CARUOLO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9218 PORTAGE DR UNIT 105
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8396
Mailing Address - Country:US
Mailing Address - Phone:910-260-1041
Mailing Address - Fax:
Practice Address - Street 1:16455 STATESVILLE RD STE 300
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7139
Practice Address - Country:US
Practice Address - Phone:704-801-3718
Practice Address - Fax:704-801-3705
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19393225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist