Provider Demographics
NPI:1679161434
Name:CARTER, LAUREL ELISABETH (PTA)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:ELISABETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 LAUREL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-3134
Mailing Address - Country:US
Mailing Address - Phone:828-765-7213
Mailing Address - Fax:
Practice Address - Street 1:218 LAUREL CREEK CT
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-3134
Practice Address - Country:US
Practice Address - Phone:828-765-7213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA7113225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant