Provider Demographics
NPI:1306833629
Name:CARR, JOEL CHRISTOPHER (DC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:CHRISTOPHER
Last Name:CARR
Suffix:
Gender:M
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:PO BOX 1037
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:52361-1037
Mailing Address - Country:US
Mailing Address - Phone:319-668-2866
Mailing Address - Fax:
Practice Address - Street 1:502 ELM ST.
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:IA
Practice Address - Zip Code:52361-1037
Practice Address - Country:US
Practice Address - Phone:319-668-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILV05226Medicare UPIN