Individual
BRUCE COWIN CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4096 DELA PALMA RD, WILLIAMSBURG, OH 45176-9712
(513) 724-7448
Mailing address
PO BOX 646, WILLIAMSBURG, OH 45176-0646
(513) 724-7448
(513) 724-1174
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1301040
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2504310
—
OH
Enumeration date
11/30/2020
Last updated
11/30/2020
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