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General NPI Number Information
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NPI Number | 1346113230
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Entity Type | Individual
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Provider Name | AUSTIN CARPENTER
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Gender | Male
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 858 COMMERCE DR
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City | SMELTERVILLE
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State | ID
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Zip | 83839
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Country | US
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Telephone | 208-784-4607
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Fax |
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Provider Business Mailing Address
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Address Line | 12103 ELLINGSWORTH LN
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City | LOUISVILLE
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State | KY
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Zip | 40243-1901
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 009270
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License Number State | KY
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