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Individual
ANDREA CARTER
Active
Individual
ANDREA CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-013901
ILLINOIS STATE LICENSE
IL
01
—
753210
MEDICARE GROUP
IL
01
—
CF2064
RAILROAD GROUP
IL
Enumeration date
07/18/2006
Last updated
06/03/2019
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