Provider Demographics
NPI:1750622791
Name:HELMERICH, CAROL DELPHINA (MPT)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:DELPHINA
Last Name:HELMERICH
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:DELPHINA
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:BIW-6045
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-721-2482
Mailing Address - Fax:706-721-8168
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:BIW-6045
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0004
Practice Address - Country:US
Practice Address - Phone:706-721-2482
Practice Address - Fax:706-721-8168
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT003420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist