Provider Demographics
NPI:1891173365
Name:PIRTLE, CAROLINE (COTA/L)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:PIRTLE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 BROOKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-2812
Mailing Address - Country:US
Mailing Address - Phone:770-710-6969
Mailing Address - Fax:
Practice Address - Street 1:204 BROOKSTONE DR
Practice Address - Street 2:
Practice Address - City:MT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-2812
Practice Address - Country:US
Practice Address - Phone:770-710-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8293224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant