Provider Demographics
NPI:1881818094
Name:SCHILLER, CAROLYN ANN (ATC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ANN
Last Name:SCHILLER
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 1:2505 COLGRAVE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3766
Mailing Address - Country:US
Mailing Address - Phone:804-519-5457
Mailing Address - Fax:
Practice Address - Street 1:2505 COLGRAVE RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3766
Practice Address - Country:US
Practice Address - Phone:804-519-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260007492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0126000749OtherSTATE LICENSE