Provider Demographics
NPI:1558792044
Name:CARTER, JAMIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:KNORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:519 GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-5702
Mailing Address - Country:US
Mailing Address - Phone:217-440-9198
Mailing Address - Fax:
Practice Address - Street 1:310 W PLAZA DR
Practice Address - Street 2:
Practice Address - City:CARTERVILLE
Practice Address - State:IL
Practice Address - Zip Code:62918-1980
Practice Address - Country:US
Practice Address - Phone:217-440-9198
Practice Address - Fax:618-985-6469
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor