Healthcare Provider Details

I. General information

NPI: 1255889341
Provider Name (Legal Business Name): CHRISTY C CARWILE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2016
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 LAKEWOOD DR STE 2
BATESVILLE MS
38606-3017
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 662-563-2579
  • Fax: 662-563-2580
Mailing address:
  • Phone: 630-575-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT0890
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: