Healthcare Provider Details

I. General information

NPI: 1215264130
Provider Name (Legal Business Name): JAMES EDWARD HARREN CARTER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 BRYAN STATION RD #110
LEXINGTON KY
40505-2138
US

IV. Provider business mailing address

845 GLEN ABBEY CIR
LEXINGTON KY
40509-1911
US

V. Phone/Fax

Practice location:
  • Phone: 859-293-6133
  • Fax:
Mailing address:
  • Phone: 859-806-9335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number005529
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: