Provider Demographics
NPI:1881231561
Name:ERNEST, CAROLINE ROSE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ROSE
Last Name:ERNEST
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5718
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-5718
Mailing Address - Country:US
Mailing Address - Phone:406-756-0134
Mailing Address - Fax:406-309-2579
Practice Address - Street 1:265 WALNUTWOOD TRL
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2303
Practice Address - Country:US
Practice Address - Phone:470-207-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist