Provider Demographics
NPI:1720525298
Name:KLEMENTOWICZ, CARRIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:KLEMENTOWICZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 INDUSTRIAL WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4291
Mailing Address - Country:US
Mailing Address - Phone:603-335-4700
Mailing Address - Fax:603-335-4704
Practice Address - Street 1:36 INDUSTRIAL WAY STE 1
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-4291
Practice Address - Country:US
Practice Address - Phone:603-335-4700
Practice Address - Fax:603-335-4704
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist