Provider Demographics
NPI:1972742773
Name:YBALLE, CARLA T (PT)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:T
Last Name:YBALLE
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:NMRTC OKINAWA
Mailing Address - Street 2:PSC 482
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362-2999
Mailing Address - Country:US
Mailing Address - Phone:080-943-6989
Mailing Address - Fax:
Practice Address - Street 1:BLDG. 9497 KAB PSC 4821
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96362
Practice Address - Country:US
Practice Address - Phone:098-634-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist