Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1285905349 |
---|---|
Provider Name | Robert Lee Carter |
First Address | Farmington, MI 48336-3267 |
Second Address | Farmington, MI 48336-3267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2012 |
Last Update Date | 21/01/2012 |