Provider Demographics
NPI:1043078348
Name:CARNAHAN CHIROPRACTIC
Entity Type:Organization
Organization Name:CARNAHAN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-217-1040
Mailing Address - Street 1:16 W MAIN ST STE M3
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-1156
Mailing Address - Country:US
Mailing Address - Phone:315-217-1040
Mailing Address - Fax:
Practice Address - Street 1:16 W MAIN ST STE M3
Practice Address - Street 2:
Practice Address - City:MARCELLUS
Practice Address - State:NY
Practice Address - Zip Code:13108-1156
Practice Address - Country:US
Practice Address - Phone:315-217-1040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty