Provider Demographics
NPI:1528582467
Name:SMITH, CARTER D (DPT)
Entity Type:Individual
Prefix:
First Name:CARTER
Middle Name:D
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:10560 LIGON MILL ROAD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-556-4678
Mailing Address - Fax:919-556-4619
Practice Address - Street 1:10560 LIGON MILL ROAD
Practice Address - Street 2:SUITE 109
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-556-4678
Practice Address - Fax:919-556-4619
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2018-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCP17335225100000X
NC17335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist