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General NPI Number Information
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NPI Number | 1972244002
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Entity Type | Individual
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Provider Name | JAMIE CARLSON PT,DPT
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 1841 LANE RD
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City | COLUMBUS
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State | OH
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Zip | 43220-3007
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Country | US
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Telephone | 937-609-7362
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Fax |
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Provider Business Mailing Address
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Address Line | 65 E WADSWORTH PARK DR STE 230
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City | DRAPER
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State | UT
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Zip | 84020-8096
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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 | 013366
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License Number State | OH
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