Provider Demographics
NPI:1710319934
Name:HARBOLD, CARRIE ANN (ATC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:HARBOLD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 MULSONBURG RD
Mailing Address - Street 2:
Mailing Address - City:FRENCHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16836-8943
Mailing Address - Country:US
Mailing Address - Phone:814-592-2648
Mailing Address - Fax:
Practice Address - Street 1:258 MULSONBURG RD
Practice Address - Street 2:
Practice Address - City:FRENCHVILLE
Practice Address - State:PA
Practice Address - Zip Code:16836-8943
Practice Address - Country:US
Practice Address - Phone:814-592-2648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer