Provider Demographics
NPI:1346404282
Name:CARNES CHIROPRACTIC
Entity Type:Organization
Organization Name:CARNES CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-720-7322
Mailing Address - Street 1:307 40TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1621
Mailing Address - Country:US
Mailing Address - Phone:304-720-7322
Mailing Address - Fax:
Practice Address - Street 1:307 40TH ST SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1621
Practice Address - Country:US
Practice Address - Phone:304-720-7322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2189-6593261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1710915665OtherINDIVIDUAL NPI #