Provider Demographics
NPI:1811591704
Name:DR COLBY J CARTER LLC
Entity Type:Organization
Organization Name:DR COLBY J CARTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-680-0754
Mailing Address - Street 1:8825 S 117TH ST
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-5567
Mailing Address - Country:US
Mailing Address - Phone:402-597-2869
Mailing Address - Fax:
Practice Address - Street 1:8825 S 117TH ST
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-5567
Practice Address - Country:US
Practice Address - Phone:402-597-2869
Practice Address - Fax:402-507-2536
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR COLBY J CARTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty