Provider Demographics
NPI:1477734135
Name:CARB CC TWO LLC
Entity Type:Organization
Organization Name:CARB CC TWO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:MERLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-282-1240
Mailing Address - Street 1:267 BROOKLYN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-2829
Mailing Address - Country:US
Mailing Address - Phone:570-282-1240
Mailing Address - Fax:570-282-7937
Practice Address - Street 1:267 BROOKLYN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2829
Practice Address - Country:US
Practice Address - Phone:570-282-1240
Practice Address - Fax:570-282-7937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004100L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA590360Medicare PIN