Provider Demographics
NPI:1821234022
Name:CARTER, KATIE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:MARIE
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 1:1119 CENTRAL AVE
Mailing Address - Street 2:PO BOX 11
Mailing Address - City:ESTHERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51334-2430
Mailing Address - Country:US
Mailing Address - Phone:712-362-2336
Mailing Address - Fax:712-362-2336
Practice Address - Street 1:1119 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ESTHERVILLE
Practice Address - State:IA
Practice Address - Zip Code:51334-2430
Practice Address - Country:US
Practice Address - Phone:712-362-2336
Practice Address - Fax:712-362-2336
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2023-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IB1439Medicare UPIN