Provider Demographics
NPI:1639378722
Name:CARR, WAYNE SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:SCOTT
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 1:711 HEALDSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3671
Mailing Address - Country:US
Mailing Address - Phone:707-431-7255
Mailing Address - Fax:707-431-7256
Practice Address - Street 1:711 HEALDSBURG AVE
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3671
Practice Address - Country:US
Practice Address - Phone:707-431-7255
Practice Address - Fax:707-431-7256
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19403111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor