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NPI Code Detail

MEDICARE: MRS. JESSICA LAUREN CARTER MSPT

MEDICARE: MRS. JESSICA LAUREN CARTER MSPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist0400047331VT

General Provider Information

NPI Number : 1790915940
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA LAUREN CARTER MSPT
Provider Business Mailing Address
First Line : 21 ESSEX WAY
Second Line : SUITE 116
City : ESSEX JUNCTION
State : VT
Zip : 05452-3385
Country : US
Telephone Number : 802-879-8300
Fax Number : 802-879-9300
Provider Business Practice Location Address
First Line : 14901 CAREY RD
Second Line :
City : CARMEL
State : IN
Zip : 46033-6000
Country : US
Telephone Number : 877-407-3422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2009
Last Update Date : 12/24/2024

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