Provider Demographics
NPI:1497930747
Name:CAROLE, ERICA (MT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CAROLE
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 HUMPHREY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4580
Mailing Address - Country:US
Mailing Address - Phone:724-838-0527
Mailing Address - Fax:
Practice Address - Street 1:245 HUMPHREY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4580
Practice Address - Country:US
Practice Address - Phone:724-838-0527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist