Provider Demographics
NPI:1205906252
Name:DIAZ-CARPENTER, ADAMY D (LMT, NCBTMBP)
Entity type:Individual
Prefix:
First Name:ADAMY
Middle Name:D
Last Name:DIAZ-CARPENTER
Suffix:
Gender:F
Credentials:LMT, NCBTMBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W POINSETT ST
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1451
Mailing Address - Country:US
Mailing Address - Phone:864-848-1232
Mailing Address - Fax:864-989-0106
Practice Address - Street 1:701 W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1451
Practice Address - Country:US
Practice Address - Phone:864-848-1232
Practice Address - Fax:864-989-0106
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171R00000X
SC2846171W00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171R00000XOther Service ProvidersInterpreter
No171W00000XOther Service ProvidersContractor