MEDICARE: JUSTIN AARON CARR PT

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
1	208100000X	Physical Medicine & Rehabilitation Physician	PT24997	CA

General Provider Information

NPI Number	:	1447940978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN AARON CARR PT

Provider Business Mailing Address
First Line	:	5237 T ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-4838
Country	:	US
Telephone Number	:	916-212-6676
Fax Number	:

Provider Business Practice Location Address
First Line	:	5237 T ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-4838
Country	:	US
Telephone Number	:	916-212-6676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	05/09/2023

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