Provider Demographics
NPI:1548772247
Name:CARR, ADAM JOSHUA (DC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JOSHUA
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 99
Mailing Address - Street 2:
Mailing Address - City:OWEN
Mailing Address - State:WI
Mailing Address - Zip Code:54460-0099
Mailing Address - Country:US
Mailing Address - Phone:715-229-2113
Mailing Address - Fax:715-229-4816
Practice Address - Street 1:107 S HARDING ST
Practice Address - Street 2:
Practice Address - City:OWEN
Practice Address - State:WI
Practice Address - Zip Code:54460-9737
Practice Address - Country:US
Practice Address - Phone:715-229-2113
Practice Address - Fax:715-229-4816
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5655-12111N00000X
SD1319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor