Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0104556161 | VA |
N | 111NN1001X | Nutrition | 0104556161 | VA |
NPI | 1548577927 |
---|---|
Provider Name | Dr. Anthony W Carpenter |
First Address | Arlington, VA 22204 |
Second Address | Arlington, VA 22204-1655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 24/11/2010 |