Provider Demographics
NPI:1518391648
Name:DESMIDT, CARY (DC)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:
Last Name:DESMIDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 HARBOR POINTE DR
Mailing Address - Street 2:10
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3481
Mailing Address - Country:US
Mailing Address - Phone:781-291-0990
Mailing Address - Fax:
Practice Address - Street 1:454 W COLEMAN BLVD
Practice Address - Street 2:SUITE 2A
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5653
Practice Address - Country:US
Practice Address - Phone:843-654-4540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3830111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor