Provider Demographics
NPI:1609001650
Name:CARTER CHIROPRACTIC & ACCUPUNCTURE CENTER PC
Entity Type:Organization
Organization Name:CARTER CHIROPRACTIC & ACCUPUNCTURE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-886-5100
Mailing Address - Street 1:1200 E WOODHURST DR STE Q400
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3744
Mailing Address - Country:US
Mailing Address - Phone:417-886-5100
Mailing Address - Fax:417-886-5146
Practice Address - Street 1:1200 E WOODHURST DR STE Q400
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3744
Practice Address - Country:US
Practice Address - Phone:417-886-5100
Practice Address - Fax:417-886-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000031909Medicare PIN