Basic Information
| Provider Information | |||||||||
| NPI: | 1235762352 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARUOLO | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | PEARSON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9218 PORTAGE DR UNIT 105 | ||||||||
| Address2: | |||||||||
| City: | CORNELIUS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280318396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102601041 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16455 STATESVILLE RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | HUNTERSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280787139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048013718 | ||||||||
| FaxNumber: | 7048013705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2020 | ||||||||
| LastUpdateDate: | 02/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | P19393 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.