Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501002989 | MI |
NPI | 1003063553 |
---|---|
Provider Name | Carol Casolari |
First Address | Toledo, OH 43606-1326 |
Second Address | West Bloomfield, MI 48322-4406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 26/08/2008 |