Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC005850L | PA |
N | 111NN1001X | Nutrition | DC005850L | PA |
N | 111NP0017X | Pediatric Chiropractor | DC005850L | PA |
NPI | 1124270376 |
---|---|
Provider Name | Dr. Elizabeth Kroculick Carter |
First Address | Berwyn, PA 19312-1673 |
Second Address | Berwyn, PA 19312-1673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 21/10/2008 |