Provider Demographics
NPI:1073703435
Name:TINA A. CARTER, D.C., INC.
Entity Type:Organization
Organization Name:TINA A. CARTER, D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-753-1361
Mailing Address - Street 1:400 INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2104
Mailing Address - Country:US
Mailing Address - Phone:270-753-1361
Mailing Address - Fax:270-753-1369
Practice Address - Street 1:400 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2104
Practice Address - Country:US
Practice Address - Phone:270-753-1361
Practice Address - Fax:270-753-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4240111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYU50480Medicare UPIN