Individual provider · Type 1 NPI

Ethan Lane Carroll

Physical Therapy Assistant · Mc Lean, VA

NPI number 1548855141 Active

Practice location

6858 Old Dominion Dr Ste 200
Mc Lean, VA 22101-3832

Mailing address

8496 Canyon Oak Dr
Springfield, VA 22153-3576

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X2306605698 (VA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1548855141

Ethan Lane Carroll's National Provider Identifier is 1548855141, issued on Mar 4, 2021. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Mc Lean, VA. The record was last updated on Mar 4, 2021.