Provider Demographics
NPI:1134772510
Name:CARTER, JEAN MARIE (DPT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:MARIE
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6884 HICKORY FLAT HWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3229
Mailing Address - Country:US
Mailing Address - Phone:770-704-8244
Mailing Address - Fax:
Practice Address - Street 1:709 CANTON RD NE STE 120
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8971
Practice Address - Country:US
Practice Address - Phone:770-792-7522
Practice Address - Fax:770-792-7508
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist