Provider Demographics
NPI:1962663062
Name:CARR, THERESA A (ARCB REFLEXOLOGIST)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:CARR
Suffix:
Gender:F
Credentials:ARCB REFLEXOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 GREENWOODS RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-2330
Mailing Address - Country:US
Mailing Address - Phone:860-489-2613
Mailing Address - Fax:860-489-2613
Practice Address - Street 1:519 GREENWOODS RD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-2330
Practice Address - Country:US
Practice Address - Phone:860-489-2613
Practice Address - Fax:860-489-2613
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist