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General NPI Number Information
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NPI Number | 1730479726
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Entity Type | Individual
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Provider Name | CHESTER T. CARTER LMT
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Gender | Male
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 1860 VIRGINIA AVE, SUITE 11
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City | NORTH BEND
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State | OR
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Zip | 97459-2355
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Country | US
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Telephone | 541-267-2398
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Fax | 541-808-3939
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Provider Business Mailing Address
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Address Line | 1860 VIRGINIA AVE STE 11
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City | NORTH BEND
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State | OR
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Zip | 97459-2355
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Country | US
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Telephone | 541-267-2398
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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 | 3804
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License Number State | OR
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