Phillip Sean Carroll, DPT
Individual provider Active NPI Physical Therapist · Tullahoma, TN
NPI 1457935686 · NPPES record last updated May 12, 2021
Key facts
- NPI
- 1457935686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 13333 (TN)
- Practice address
- 1821 N Washington St
Tullahoma, TN 37388-2221 - Phone
- (931) 222-4454
- NPI assigned
- May 12, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019022794 | MO | MD | Physical Therapist |
| 13333 | TN | MD | Physical Therapist |
| 1318710 | TX | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2019022794 | MO | |
| Physical Therapist | 225100000X | 1318710 | TX | |
| Physical Therapist | 225100000X | 13333 | TN | Yes |
Addresses
Primary practice location
1821 N Washington St
Tullahoma, TN 37388-2221
Mailing address
446 N Claud Ave
Bolivar, MO 65613-1424
Phone (925) 278-3176
Other providers in Tullahoma, TN
- Cardiology & Vascular Associates
- Cardiology Group, PC
- Caris Healthcare
- Jessica Carpenter
- Mark Allen Carrick
- Kristina Danette Carter
- Cataract Care, PLLC
- Aubrey Martin Cawthon Jr.
- Center for Day Surgery
- Centerstone
All providers in Tullahoma, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.