Provider Demographics
NPI:1891248290
Name:CARTER HEALTH & WELLNESS PA
Entity Type:Organization
Organization Name:CARTER HEALTH & WELLNESS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-470-7406
Mailing Address - Street 1:4325 NICOLLET AVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-2032
Mailing Address - Country:US
Mailing Address - Phone:612-226-9432
Mailing Address - Fax:612-235-6873
Practice Address - Street 1:4325 NICOLLET AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-2032
Practice Address - Country:US
Practice Address - Phone:612-226-9432
Practice Address - Fax:612-235-6873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty