Provider Demographics
NPI:1386039212
Name:CARTER, BRANT CHRISTIAN (LIC AC, DIPL OM)
Entity Type:Individual
Prefix:MR
First Name:BRANT
Middle Name:CHRISTIAN
Last Name:CARTER
Suffix:
Gender:M
Credentials:LIC AC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 WASHINGTON ST
Mailing Address - Street 2:NO. 115
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6219
Mailing Address - Country:US
Mailing Address - Phone:781-591-7597
Mailing Address - Fax:
Practice Address - Street 1:332 WASHINGTON ST
Practice Address - Street 2:NO. 115
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-6219
Practice Address - Country:US
Practice Address - Phone:781-591-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-28
Last Update Date:2015-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA263289OtherBOARD OF REGISTRATION IN MEDICINE