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General NPI Number Information
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NPI Number | 1821863762
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Entity Type | Individual
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Provider Name | MICHAEL CARROLL
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Gender | Male
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 745 N HIGHLAND AVE
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City | PITTSBURGH
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State | PA
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Zip | 15206-2526
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Country | US
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Telephone | 304-904-6583
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Fax |
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Provider Business Mailing Address
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Address Line | 1166 MURRAY HILL AVE
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City | PITTSBURGH
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State | PA
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Zip | 15217-1042
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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 | PT021120
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License Number State | PA
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