Provider Demographics
NPI:1831561117
Name:CARMICHAEL, KARINA (ATC)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 MARSHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-9312
Mailing Address - Country:US
Mailing Address - Phone:862-571-8793
Mailing Address - Fax:
Practice Address - Street 1:303 S OTTERBEIN AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2333
Practice Address - Country:US
Practice Address - Phone:862-571-8793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0047692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer