Provider Demographics
NPI:1134764020
Name:CARROLL, ERIN LEE (DPT)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LEE
Last Name:CARROLL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:35 MILL COMMONS DR UNIT 220
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8114
Mailing Address - Country:US
Mailing Address - Phone:858-602-9144
Mailing Address - Fax:
Practice Address - Street 1:88 HARBOR DR
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072
Practice Address - Country:US
Practice Address - Phone:207-283-3646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4599208100000X
ME5519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation