Individual
CARTER JOE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10201 N PINE BLUFF DR, BICKNELL, IN 47512-8244
(812) 910-0673
Mailing address
10201 N PINE BLUFF DR, BICKNELL, IN 47512-8244
(812) 910-0673
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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