Provider Demographics
NPI:1376763193
Name:WARFEL, CARRIE GORDON LARSON (PT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:GORDON LARSON
Last Name:WARFEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 GARRETT RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-9743
Mailing Address - Country:US
Mailing Address - Phone:410-357-9437
Mailing Address - Fax:
Practice Address - Street 1:2601 GARRETT RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:MD
Practice Address - Zip Code:21161-9743
Practice Address - Country:US
Practice Address - Phone:410-357-9437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18904225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist