Provider Demographics
NPI:1659591675
Name:CARTER CHIROPRACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:CARTER CHIROPRACTIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AVA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-246-9353
Mailing Address - Street 1:1567 N EASTMAN RD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-2683
Mailing Address - Country:US
Mailing Address - Phone:423-246-9353
Mailing Address - Fax:423-246-8849
Practice Address - Street 1:1567 N EASTMAN RD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-2683
Practice Address - Country:US
Practice Address - Phone:423-246-9353
Practice Address - Fax:423-246-8849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1431261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center