Provider Demographics
NPI:1265551287
Name:MAUPIN-WHEELOCK, CAROL M (PT,MBA,CERT MDT)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:M
Last Name:MAUPIN-WHEELOCK
Suffix:
Gender:
Credentials:PT,MBA,CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 632476
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2476
Mailing Address - Country:US
Mailing Address - Phone:423-282-5435
Mailing Address - Fax:423-282-5767
Practice Address - Street 1:313 PRINCETON RD STE 3
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-282-5435
Practice Address - Fax:423-282-5767
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000001152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist