Provider Demographics
NPI:1508157405
Name:CARTER, RONALD S (DC, LMT)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:S
Last Name:CARTER
Suffix:
Gender:M
Credentials:DC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 HUNT CLUB LN APT A
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-5405
Mailing Address - Country:US
Mailing Address - Phone:302-898-7294
Mailing Address - Fax:
Practice Address - Street 1:1020 HUNT CLUB LN APT A
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-5405
Practice Address - Country:US
Practice Address - Phone:302-898-7294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0001043174400000X
SC4146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No174400000XOther Service ProvidersSpecialist