Healthcare Provider Details

I. General information

NPI: 1013531490
Provider Name (Legal Business Name): KRISTEN CARTER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN ZIEGLER LMT

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 06/10/2020
Certification Date: 06/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8390 E KEMPER RD STE A
CINCINNATI OH
45249-1600
US

IV. Provider business mailing address

661 W MAIN ST
BLANCHESTER OH
45107-9401
US

V. Phone/Fax

Practice location:
  • Phone: 513-774-9800
  • Fax: 888-315-2865
Mailing address:
  • Phone: 513-774-9800
  • Fax: 888-315-2865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.016949
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: