Provider Demographics
NPI:1891352001
Name:MATHIOT, CAROLYN E (PTA)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:E
Last Name:MATHIOT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 BELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1303
Mailing Address - Country:US
Mailing Address - Phone:919-618-0499
Mailing Address - Fax:
Practice Address - Street 1:1300 CORPORATION PKWY STE B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1362
Practice Address - Country:US
Practice Address - Phone:919-917-7729
Practice Address - Fax:919-400-4178
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant