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General NPI Number Information
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NPI Number | 1457716672
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Entity Type | Individual
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Provider Name | CAROLINE BACH
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Gender | Female
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Dates
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Enumeration Date | 12/15/2015
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 109 CROFTON PL
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City | PALMYRA
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State | VA
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Zip | 22963
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Country | US
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Telephone | 434-589-9588
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Fax | 434-589-4096
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Provider Business Mailing Address
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Address Line | 1377 MOTOR PKWY STE 307
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City | ISLANDIA
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State | NY
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Zip | 11749-5258
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Country | US
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Telephone | 631-580-5200
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Fax | 631-580-5222
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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 | PT 43131
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305211118
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License Number State | VA
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