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NPI Code Detail

MEDICARE: LAURA ELIZABETH CARRIERO PTA

MEDICARE:   LAURA ELIZABETH CARRIERO  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA003860GA

General Provider Information

NPI Number : 1003330051
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ELIZABETH CARRIERO PTA
Provider Business Mailing Address
First Line : 6397 LEE HWY STE 300
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-2564
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-362-8684
Provider Business Practice Location Address
First Line : 105 N MAIN ST STE C
Second Line :
City : CLEVELAND
State : GA
Zip : 30528-1123
Country : US
Telephone Number : 706-219-4507
Fax Number : 706-865-1501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2017
Last Update Date : 08/01/2017

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Directions to “ LAURA ELIZABETH CARRIERO PTA” Practice Location

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