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General NPI Number Information
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NPI Number | 1346830700
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Entity Type | Individual
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Provider Name | DEBORAH CARTER LMT
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Gender | Female
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 340 I ST
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City | LOS BANOS
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State | CA
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Zip | 93635-4143
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Country | US
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Telephone | 209-210-2116
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 E 23RD ST
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City | MERCED
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State | CA
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Zip | 95340-4143
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Country | US
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Telephone | 510-329-5076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 72664
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License Number State | CA
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