Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Lane Carroll

Individual provider Physical Therapy Assistant · NPI 1548855141

Ethan Lane Carroll is a Physical Therapy Assistant in Mc Lean, Virginia. Licensed in Virginia. Registered with an NPI since 2021.

Licensed in
VA
In the registry since
2021

Practice location Address checks out

6858 Old Dominion Dr Ste 200
Mc Lean, VA 22101-3832
Phone: (703) 288-8260
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2306605698 (VA)

Record details

NPI number1548855141
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 4, 2021
Last updated in NPPESMarch 4, 2021
Certification dateMarch 4, 2021
Mailing address8496 Canyon Oak Dr, Springfield, VA 22153-3576

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