Healthcare Provider Details
I. General information
NPI: 1306129564
Provider Name (Legal Business Name): CARRIE YOUMANS PT DPT CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/23/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
220 STEUBEN ST
MONTOUR FALLS NY
14865-9740
US
IV. Provider business mailing address
220 STEUBEN ST
MONTOUR FALLS NY
14865-9740
US
V. Phone/Fax
- Phone: 607-535-8639
- Fax: 607-210-1965
- Phone: 607-535-8639
- Fax: 607-210-1965
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 032270-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: