Provider Demographics
NPI:1801193818
Name:CARTER, JENNIFER LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEIGH
Last Name:CARTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 22ND CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-2109
Mailing Address - Country:US
Mailing Address - Phone:772-766-3311
Mailing Address - Fax:
Practice Address - Street 1:9613 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-6363
Practice Address - Country:US
Practice Address - Phone:772-918-4547
Practice Address - Fax:772-918-8169
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor