Provider Demographics
NPI:1134197320
Name:CO, CAROLINE JOY YUMUL
Entity type:Individual
Prefix:
First Name:CAROLINE JOY
Middle Name:YUMUL
Last Name:CO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 N SPENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4263
Mailing Address - Country:US
Mailing Address - Phone:919-751-0555
Mailing Address - Fax:919-751-3001
Practice Address - Street 1:605 N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4263
Practice Address - Country:US
Practice Address - Phone:919-751-0555
Practice Address - Fax:919-751-3001
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP16455225100000X
NY024937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist