Mrs. Carrie L Deisenroth, ATC
Specialist/Technologist, Athletic Trainer in Southborough, Massachusetts
1336292440- Practice location
- 25 Marlboro RD, Southborough, MA 01772-1207
- Phone
- 508-786-6144
- Fax
- 508-786-6139
- Last updated
- July 8, 2007
Carrie Lynn Deisenroth is a Specialist/Technologist, Athletic Trainer based in Southborough, MA. Carrie Lynn Deisenroth practices in Southborough, MA and has the professional credentials of ATC. The NPI Number for Carrie Lynn Deisenroth is 1336292440 and holds a License No. 1072 (MA). The current practice location address for Carrie Lynn Deisenroth is 25 Marlboro RD, Southborough, MA 01772-1207 and can be reached out via phone at 508-786-6144 and via fax at 508-786-6139.
Provider Profile Details
- NPI Number
- 1336292440
- Provider Name
- Carrie Lynn Deisenroth
- Credential
- ATC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 25 Marlboro RD, Southborough, MA 01772-1207
- Phone Number
- 508-786-6144
- Fax Number
- 508-786-6139
- Primary Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- Sole Proprietor
- No
- Provider Enumeration Date
- January 19, 2007
- Last Update Date
- July 8, 2007
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 25 Marlboro RD
Southborough, MA 01772-1207 - City
- Southborough
- State
- Massachusetts
- Zip
- 01772-1207
- Phone Number
- 508-786-6144
- Fax Number
- 508-786-6139
Provider Business Mailing Address Details
- Address
- 25 Marlboro RD
Southborough, MA 01772-1207 - City
- Southborough
- State
- MA
- Zip
- 01772-1207
- Phone Number
- 508-786-6144
- Fax Number
- 508-786-6139
License Information
- License Number (1)
- 1072
- License State (1)
- MA
- Taxonomy (1)
- Specialist/Technologist, Athletic Trainer · 2255A2300X · Primary
- License Number (2)
- 67 000457
- License State (2)
- NY
- Taxonomy (2)
- Specialist/Technologist, Athletic Trainer · 2255A2300X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Specialist/Technologist, Athletic Trainers near Southborough, MA
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Frequently Asked Questions
What is the NPI number of Mrs. Carrie L Deisenroth, ATC?
The NPI number of Mrs. Carrie L Deisenroth, ATC is 1336292440. It was assigned on January 19, 2007 and is currently active in the NPPES registry.
What is the specialty of Mrs. Carrie L Deisenroth, ATC?
Mrs. Carrie L Deisenroth, ATC is registered under the primary taxonomy Specialist/Technologist, Athletic Trainer (code 2255A2300X), licensed in MA under license number 1072.
Where does Mrs. Carrie L Deisenroth, ATC practice?
The practice location is 25 Marlboro RD, Southborough, MA 01772-1207. The office can be reached at 508-786-6144 (phone) or 508-786-6139 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1336292440 directly on the NPPES registry website.