Provider Demographics
NPI:1578176244
Name:CARBONE, JASMINE CELENA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:CELENA
Last Name:CARBONE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:CELENA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-0949
Mailing Address - Country:US
Mailing Address - Phone:706-507-3681
Mailing Address - Fax:706-507-3794
Practice Address - Street 1:2045 CENTRE STONE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-4561
Practice Address - Country:US
Practice Address - Phone:706-507-3794
Practice Address - Fax:706-507-3681
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist