Provider Demographics
NPI:1497065031
Name:CARTER, NATHAN ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ALLEN
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 1:608 DECATUR AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-3236
Mailing Address - Country:US
Mailing Address - Phone:352-796-7201
Mailing Address - Fax:352-796-5215
Practice Address - Street 1:291 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2699
Practice Address - Country:US
Practice Address - Phone:352-796-7201
Practice Address - Fax:352-796-5215
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEB308AMedicare PIN