Provider Demographics
NPI:1952330086
Name:DUERR, CAROLYN LEE (PT)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:LEE
Last Name:DUERR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 AMHURST BLVD
Mailing Address - Street 2:THE FITNESS CENTER
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-4294
Mailing Address - Country:US
Mailing Address - Phone:252-636-0035
Mailing Address - Fax:252-636-0036
Practice Address - Street 1:2701 AMHURST BLVD
Practice Address - Street 2:THE FITNESS CENTER
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-4294
Practice Address - Country:US
Practice Address - Phone:252-636-0035
Practice Address - Fax:252-636-0036
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC068FHOtherBCBS
NC250153Medicare PIN