Provider Demographics
NPI:1700432002
Name:CARTER YODER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CARTER YODER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:YODER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-259-5445
Mailing Address - Street 1:7855 S EMERSON AVE STE Q
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8669
Mailing Address - Country:US
Mailing Address - Phone:317-884-2636
Mailing Address - Fax:
Practice Address - Street 1:7855 S EMERSON AVE STE Q
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8669
Practice Address - Country:US
Practice Address - Phone:812-259-5445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty