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NPI 1497769129

NPI 1497769129 : TERESA CARPENTER PT : FAIRHOPE, AL

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General NPI Number Information
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    NPI Number           |    1497769129
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    Entity Type          |    Individual 
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    Provider Name        |    TERESA CARPENTER PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/28/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    351 S GREENO RD 
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    City                 |    FAIRHOPE
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    State                |    AL
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    Zip                  |    36532-1904
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    Country              |    US
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    Telephone            |    251-928-7312
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    Fax                  |    251-928-8316
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Provider Business Mailing Address
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    Address Line         |    PO BOX 851324 
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    City                 |    MOBILE
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    State                |    AL
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    Zip                  |    36685-1324
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    Country              |    US
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    Telephone            |    251-476-0525
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    Fax                  |    251-476-5724
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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       |    PTH1242
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    License Number State |    AL
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