Provider Demographics
NPI:1568965713
Name:CARLSON, BETHANY ERIN (DPT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:ERIN
Last Name:CARLSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:ERIN
Other - Last Name:SITAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5910 HARPER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-1886
Mailing Address - Country:US
Mailing Address - Phone:844-987-8765
Mailing Address - Fax:844-987-8765
Practice Address - Street 1:5910 HARPER RD STE 102
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-1886
Practice Address - Country:US
Practice Address - Phone:844-987-8765
Practice Address - Fax:844-987-8765
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT013107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist