Provider Demographics
NPI:1568530293
Name:PADALINO, CAROLYN BLAIR (DPT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:BLAIR
Last Name:PADALINO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5951 BROWNTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-1201
Mailing Address - Country:US
Mailing Address - Phone:423-504-8767
Mailing Address - Fax:
Practice Address - Street 1:7480 ZIEGLER RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3156
Practice Address - Country:US
Practice Address - Phone:423-697-2056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4113063OtherBCBS