Provider Demographics
NPI:1407178312
Name:KNOWLTON, CARRIE ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:KNOWLTON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:JEPPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 MORRIS TPKE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2931
Mailing Address - Country:US
Mailing Address - Phone:973-698-8447
Mailing Address - Fax:
Practice Address - Street 1:127 MORRIS TPKE
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2931
Practice Address - Country:US
Practice Address - Phone:973-698-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01251800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist