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General NPI Number Information
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NPI Number | 1568552925
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Entity Type | Organization
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Legal Business Name | CAROUSEL PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 500 IRVINGTON ROAD
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City | KILMARNOCK
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State | VA
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Zip | 22482
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Country | US
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Telephone | 804-435-3435
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Fax |
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Provider Business Mailing Address
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Address Line | 500 IRVINGTON ROAD P.O. BOX 128
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City | KILMARNOCK
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State | VA
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Zip | 22482
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Country | US
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Telephone | 804-435-3435
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ PHYSICAL THERAPIST
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Name | MRS. VICKI L VERMEER
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Credential | MSPT
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Telephone | 804-435-3435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2305202045
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License Number State | VA
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