Provider Demographics
NPI:1407821234
Name:CARTER, LEONARD CLAY (DC)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:CLAY
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 1:115 COSGROVE LN
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4107
Mailing Address - Country:US
Mailing Address - Phone:864-907-9071
Mailing Address - Fax:
Practice Address - Street 1:530 HOWELL RD STE 100
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2000
Practice Address - Country:US
Practice Address - Phone:864-268-8196
Practice Address - Fax:864-268-8198
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2202Medicaid
SCCH2202Medicaid