Provider Demographics
NPI:1235205121
Name:BURNETT-STRONG, CARRIE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ANN
Last Name:BURNETT-STRONG
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 1:2200 E CEDAR AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-1958
Mailing Address - Country:US
Mailing Address - Phone:928-779-0033
Mailing Address - Fax:928-779-0036
Practice Address - Street 1:2200 E CEDAR AVE STE 2
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1958
Practice Address - Country:US
Practice Address - Phone:928-779-0033
Practice Address - Fax:928-779-0036
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U95370Medicare UPIN
AZZ126579Medicare PIN
102230Medicare UPIN