NPI 1114145331 · live from the CMS NPI Registry
Carley Michelle Anderson, PTA
Physical Therapist in Fort Worth, TX. National Provider Identifier 1114145331, active.
NPI record
| NPI | 1114145331 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 3401 Amador Dr, Fort Worth, TX 76177 |
| Practice phone | 682-204-0853 |
| Mailing address | 12880 Ns 3590, Wewoka, OK 74884 |
| Enumerated | April 23, 2007 |
| Last updated | July 14, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | NONE |
| Physical Therapist primary | 225100000X | 2162102 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.