Provider Demographics
NPI:1407064769
Name:MACHEN, CAROL WILLIAMS (PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:WILLIAMS
Last Name:MACHEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6017 GREYSTONE PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2629
Mailing Address - Country:US
Mailing Address - Phone:334-271-6452
Mailing Address - Fax:334-271-6452
Practice Address - Street 1:300 INTERSTATE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-5427
Practice Address - Country:US
Practice Address - Phone:334-272-0313
Practice Address - Fax:334-272-0448
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist