Provider Demographics
NPI:1689158339
Name:CARROLL, WILLIAM J (DPT, PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:CARROLL
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:924 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1110
Mailing Address - Country:US
Mailing Address - Phone:716-282-2888
Mailing Address - Fax:716-285-1281
Practice Address - Street 1:924 MAIN ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1110
Practice Address - Country:US
Practice Address - Phone:716-282-2888
Practice Address - Fax:716-285-1281
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist