Ethan Lane Carroll
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 200Mc Lean, VA 22101-3832
Phone: (703) 288-8260
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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 number | 1548855141 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 4, 2021 |
| Last updated in NPPES | March 4, 2021 |
| Certification date | March 4, 2021 |
| Mailing address | 8496 Canyon Oak Dr, Springfield, VA 22153-3576 |
Other providers in Mc Lean
-
Mr. John Bult, LPTA
6506 Beverly Ave, Mc Lean, VA 22101-5220 · (202) 236-7535
-
Bukunola Caillier
6251 Old Dominion Dr, Mc Lean, VA 22101-4827 · (703) 506-6900
-
Justin Meade Griggs
6858 Old Dominion Dr Ste 200, Mc Lean, VA 22101-3832 · (571) 215-8377
-
Robert Fitzgerald Pereddo, LPTA
1739 Kirby Rd, Mc Lean, VA 22101-4817 · (703) 506-6900
-
MS. Mersal Zaman
6858 Old Dominion Dr, Mc Lean, VA 22101-3899 · (703) 980-1199