Healthcare Provider Details

I. General information

NPI: 1700900537
Provider Name (Legal Business Name): HEATHER J CARABIN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S. BEST AVENUE
WALNUTPORT PA
18088-1217
US

IV. Provider business mailing address

100 SUFFOLK DRIVE
HARRISBURG PA
17112
US

V. Phone/Fax

Practice location:
  • Phone: 610-760-1520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015030
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: