Provider Demographics
NPI: | 1740695147 |
---|---|
Name: | CARTER FAMILY CHIROPRACTIC |
Entity type: | Organization |
Organization Name: | CARTER FAMILY CHIROPRACTIC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | LAUREN |
Authorized Official - Middle Name: | N |
Authorized Official - Last Name: | CARTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 636-295-1497 |
Mailing Address - Street 1: | 101 W COLLEGE ST STE 2 |
Mailing Address - Street 2: | |
Mailing Address - City: | TROY |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63379-1124 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 636-775-2500 |
Mailing Address - Fax: | 855-615-3547 |
Practice Address - Street 1: | 101 W COLLEGE ST STE 2 |
Practice Address - Street 2: | |
Practice Address - City: | TROY |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63379-1124 |
Practice Address - Country: | US |
Practice Address - Phone: | 636-775-2500 |
Practice Address - Fax: | 855-615-3547 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-06-24 |
Last Update Date: | 2025-04-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | 2012032792 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |