Provider Demographics
NPI:1770612392
Name:DUBBELS, CAROL MARIE (MPT)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:MARIE
Last Name:DUBBELS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:MARIE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:6550 YORK AVE S STE 600
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2367
Mailing Address - Country:US
Mailing Address - Phone:952-941-3311
Mailing Address - Fax:952-944-2004
Practice Address - Street 1:6550 YORK AVE S STE 600
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2367
Practice Address - Country:US
Practice Address - Phone:952-941-3311
Practice Address - Fax:952-944-2004
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR05356225100000X
WAPT61239273225100000X
TX1168328225100000X
MN12918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist