Individual
KELLY E CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
413 COLEWOOD DR, MOUNTAIN HOME, AR 72653-4175
(870) 425-8558
Mailing address
212 WILLOWESQUE CT, MOUNTAIN HOME, AR 72653-5674
(870) 405-1115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2001
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152364721
—
AR
Enumeration date
03/15/2007
Last updated
07/16/2024
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