Basic Information
| Provider Information | |||||||||
| NPI: | 1942628011 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESCH | ||||||||
| FirstName: | CARRIE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14075 S 1ST ST | ||||||||
| Address2: | STE R | ||||||||
| City: | MILAN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383586195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7316862010 | ||||||||
| FaxNumber: | 7316863798 | ||||||||
| Practice Location | |||||||||
| Address1: | 14075 S 1ST ST | ||||||||
| Address2: | STE R | ||||||||
| City: | MILAN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383586195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7316862010 | ||||||||
| FaxNumber: | 7316863798 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2014 | ||||||||
| LastUpdateDate: | 04/04/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 8992 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.