Healthcare Provider Details

I. General information

NPI: 1548212103
Provider Name (Legal Business Name): BRETT CARTER HIGHTOWER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 WAKE FOREST RD
RALEIGH NC
27609-7844
US

IV. Provider business mailing address

1705 PACIFIC DR
RALEIGH NC
27609-8106
US

V. Phone/Fax

Practice location:
  • Phone: 919-873-2225
  • Fax: 919-873-2220
Mailing address:
  • Phone: 919-873-2225
  • Fax: 919-873-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2106
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: