Provider Demographics
NPI:1982174959
Name:BARRETT, CAROLYN LOUISE
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:LOUISE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2585
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29901-2585
Mailing Address - Country:US
Mailing Address - Phone:843-524-4778
Mailing Address - Fax:843-524-4779
Practice Address - Street 1:2127 BOUNDARY ST STE 18B
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-3874
Practice Address - Country:US
Practice Address - Phone:843-524-4778
Practice Address - Fax:843-524-4779
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9408208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation