Provider Demographics
NPI:1063685097
Name:SAMUEL E. CARR, D.C., P.C.
Entity Type:Organization
Organization Name:SAMUEL E. CARR, D.C., P.C.
Other - Org Name:CARR CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-375-0589
Mailing Address - Street 1:610 N ALMA SCHOOL RD STE 24
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3688
Mailing Address - Country:US
Mailing Address - Phone:480-375-0589
Mailing Address - Fax:480-812-8983
Practice Address - Street 1:610 N ALMA SCHOOL RD STE 24
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3688
Practice Address - Country:US
Practice Address - Phone:480-375-0589
Practice Address - Fax:480-812-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDC4865Medicare PIN
AZZDC4865Medicare UPIN