Provider Demographics
NPI:1790242097
Name:MUHLHAHN, CARLY ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:ELIZABETH
Last Name:MUHLHAHN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 MILL TREE RD APT C1
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4263
Mailing Address - Country:US
Mailing Address - Phone:201-248-4109
Mailing Address - Fax:
Practice Address - Street 1:297 ELM AVE
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1216
Practice Address - Country:US
Practice Address - Phone:201-248-4109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18626225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist