Provider Demographics
NPI:1326133836
Name:TODD, CAROLYN KENNEDY (DC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:KENNEDY
Last Name:TODD
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 1:417 GROVE ACRE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950
Mailing Address - Country:US
Mailing Address - Phone:831-373-3934
Mailing Address - Fax:
Practice Address - Street 1:867 WAVE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-1054
Practice Address - Country:US
Practice Address - Phone:831-644-9900
Practice Address - Fax:831-644-9900
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor