Provider Demographics
NPI:1184957631
Name:CARROLL, CHRISTINA (ATC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 AUDUBON VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2262
Mailing Address - Country:US
Mailing Address - Phone:610-676-0411
Mailing Address - Fax:610-676-0412
Practice Address - Street 1:2804 AUDUBON VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-2262
Practice Address - Country:US
Practice Address - Phone:610-676-0411
Practice Address - Fax:610-676-0412
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0044402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer