Provider Demographics
NPI:1851019152
Name:WHITMORE, CAROL LEE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LEE
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1622 DUBLIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2840
Mailing Address - Country:US
Mailing Address - Phone:504-289-2269
Mailing Address - Fax:
Practice Address - Street 1:1484 WOODLAND HWY
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1672
Practice Address - Country:US
Practice Address - Phone:504-595-6355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01491-R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist