Provider Demographics
NPI:1457708208
Name:CARRERA, LINDSEY (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:CARRERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:CARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2190 S MASON RD STE 302
Mailing Address - Street 2:
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1637
Mailing Address - Country:US
Mailing Address - Phone:636-236-7189
Mailing Address - Fax:
Practice Address - Street 1:2190 S MASON RD
Practice Address - Street 2:SUITE 302
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-1637
Practice Address - Country:US
Practice Address - Phone:636-629-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016014203111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician