Carol Fairchild, PTA, ATC

Individual provider Active NPI Physical Therapy Assistant · Williamstown, KY

NPI 1992853782 · NPPES record last updated Aug 18, 2014

Key facts

NPI
1992853782
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A03092 (KY)
Practice address
201 Kimberly LN
Williamstown, KY 41097-9458
Phone
(859) 824-7803
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A03092KYMDPhysical Therapy Assistant
089502532KYMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A03092 KY Yes
Athletic Trainer 2255A2300X 089502532 KY

Addresses

Primary practice location

201 Kimberly LN
Williamstown, KY 41097-9458

Mailing address

1811 Whispering TRL
Union, KY 41091-9539

Other names

  • Carol Floyd Former name

Other providers in Williamstown, KY

All providers in Williamstown, KY · Physical Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.