Provider Demographics
NPI:1376890962
Name:CARVER, MOLLIE BETH (PT)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:BETH
Last Name:CARVER
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 1:1409 W BADDOUR PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2599
Mailing Address - Country:US
Mailing Address - Phone:615-444-1408
Mailing Address - Fax:615-444-1393
Practice Address - Street 1:1409 W BADDOUR PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2599
Practice Address - Country:US
Practice Address - Phone:615-444-1408
Practice Address - Fax:615-444-1393
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist