Provider Demographics
NPI:1407904071
Name:CARTER, STEVEN BRUCE (ATC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BRUCE
Last Name:CARTER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-3470
Mailing Address - Country:US
Mailing Address - Phone:313-471-2453
Mailing Address - Fax:313-471-2497
Practice Address - Street 1:2100 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-3470
Practice Address - Country:US
Practice Address - Phone:313-471-2453
Practice Address - Fax:313-471-2497
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer