Carter, Jodie L

Carter, Jodie L is an individual health care provider with primary practice located at 1500 N Westwood Blvd , Poplar Bluff MO 63901-3318. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Carter, Jodie L can be contacted via phone (573) 778-4016.

Contact Information

Primary practice address
1500 N Westwood Blvd Poplar Bluff MO 63901-3318
Phone: (573) 778-4016
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2003007040 Missouri

Profile Details

NPI number 1366408288
LBN Legal business name Carter, Jodie L
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Dec 17th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366408288 NPPES
Missouri MEDICAID 486083900

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