DR. Breeannon Carlson

NPI #1992112486 in Rockford, Illinois

Provider Information

NPI Number: 1992112486
Entity Type: Individual
Name: DR. Breeannon Carlson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Jul 16, 2014
Last Updated: Jul 16, 2014

Practice Location

Address: 5510 E STATE ST
City: Rockford
State: Illinois
ZIP Code: 61108-2381
Phone: (815) 395-4505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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