Provider Demographics
NPI:1720357155
Name:WINSCOTT, CAROL LINT (DPT)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LINT
Last Name:WINSCOTT
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 1:4454 MESA DEL ORO CT
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-3549
Mailing Address - Country:US
Mailing Address - Phone:505-473-3866
Mailing Address - Fax:
Practice Address - Street 1:8 CALLE MEDICO
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4724
Practice Address - Country:US
Practice Address - Phone:505-424-8777
Practice Address - Fax:505-424-9777
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist