Provider Demographics
NPI:1396061081
Name:BURGER, CARRIE WELLS (PT)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:WELLS
Last Name:BURGER
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 1:1005 HOY CIR
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-4302
Mailing Address - Country:US
Mailing Address - Phone:610-831-0136
Mailing Address - Fax:
Practice Address - Street 1:1005 HOY CIR
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-4302
Practice Address - Country:US
Practice Address - Phone:610-831-0136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007682L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist