Jacob Carlson
Physical Therapist in Fort Benning, GA. Individual provider (NPI-1).
NPI number1710761069
StatusActive
Last updated in NPPESMay 21, 2026
Details
- NPI
- 1710761069
- Entity type
- Individual (NPI-1)
- Name
- Jacob Carlson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 18, 2023
- Certification date
- May 21, 2026
- Last updated
- May 21, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 12528 | SC | Yes |
Practice location
6600 Van Aalst BlvdFort Benning, GA 31905-2102
Phone 762-408-2273
Mailing address
6600 Van Aalst BlvdFort Benning, GA 31905-2102
Phone 762-408-2273
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All 25 Physical Therapist providers in Fort Benning · All 547 providers in Fort Benning
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