Provider Demographics
NPI:1124270376
Name:CARTER, ELIZABETH KROCULICK (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:KROCULICK
Last Name:CARTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1673
Mailing Address - Country:US
Mailing Address - Phone:610-251-9211
Mailing Address - Fax:610-251-0228
Practice Address - Street 1:682 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1673
Practice Address - Country:US
Practice Address - Phone:610-251-9211
Practice Address - Fax:610-251-0228
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005850L111N00000X, 111NN1001X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor