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General NPI Number Information
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NPI Number | 1588631444
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Entity Type | Individual
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Provider Name | CARLA RUTH CARLSON PT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 2500 BRUNSWICK PIKE
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-4134
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Country | US
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Telephone | 609-912-0333
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Fax | 609-912-0230
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Provider Business Mailing Address
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Address Line | 31 CADWALLADER CT
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City | YARDLEY
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State | PA
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Zip | 19067-1514
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Country | US
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Telephone | 215-321-6110
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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 | 40QA01154100
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License Number State | NJ
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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 | PT 006648-L
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License Number State | PA
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