Provider Demographics
NPI:1093293169
Name:CARTER, CHRISTIAN JACOB (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:JACOB
Last Name:CARTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 PROVIDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4524
Mailing Address - Country:US
Mailing Address - Phone:314-315-6869
Mailing Address - Fax:
Practice Address - Street 1:7855 S EMERSON AVE
Practice Address - Street 2:STE Q
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237
Practice Address - Country:US
Practice Address - Phone:317-884-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003040A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor