Provider Demographics
NPI:1710164231
Name:CARP, JOHN P (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:CARP
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 294
Mailing Address - Street 2:
Mailing Address - City:EMIGRANT
Mailing Address - State:MT
Mailing Address - Zip Code:59027-0294
Mailing Address - Country:US
Mailing Address - Phone:406-333-4204
Mailing Address - Fax:
Practice Address - Street 1:12 AQUARIUS LANE
Practice Address - Street 2:
Practice Address - City:EMIGRANT
Practice Address - State:MT
Practice Address - Zip Code:59027
Practice Address - Country:US
Practice Address - Phone:406-333-4204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT484CHI111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition