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NPI Code Detail

MEDICARE: MRS. FILLISE CARTER MT

MEDICARE: MRS. FILLISE CARTER MT
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
1173C00000XReflexologistMT0094450AL

General Provider Information

NPI Number : 1831462654
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FILLISE CARTER MT
Provider Business Mailing Address
First Line : 4201 BRANDYWINE DR
Second Line :
City : PHENIX CITY
State : AL
Zip : 36869-2612
Country : US
Telephone Number : 706-393-6790
Fax Number : 706-321-0436
Provider Business Practice Location Address
First Line : 2020 7TH AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-8914
Country : US
Telephone Number : 706-323-1873
Fax Number : 706-321-0436
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2012
Last Update Date : 02/10/2012

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Directions to “ MRS. FILLISE CARTER MT” Practice Location

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