Individual
WILTON TODD CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 HARRIS INDUSTRIAL BLVD, VIDALIA, GA 30474-8852
(912) 278-1479
Mailing address
265 OAK CLIFF ST, BAXLEY, GA 31513-4480
(912) 278-1479
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT007086
GA
Other
Enumeration date
08/19/2018
Last updated
08/19/2018
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