Provider Demographics
NPI:1811032915
Name:CARR CHIROPRACTIC CLINICS PC
Entity Type:Organization
Organization Name:CARR CHIROPRACTIC CLINICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-352-5264
Mailing Address - Street 1:310 9TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:FAULKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57438
Mailing Address - Country:US
Mailing Address - Phone:605-598-6239
Mailing Address - Fax:605-598-6299
Practice Address - Street 1:310 9TH AVENUE
Practice Address - Street 2:
Practice Address - City:FAULKTON
Practice Address - State:SD
Practice Address - Zip Code:57438
Practice Address - Country:US
Practice Address - Phone:605-598-6239
Practice Address - Fax:605-598-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD595111N00000X
SD638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4999758OtherWELLMARK / BCBS
SD4999758OtherWELLMARK / BCBS
SD=========.2OtherDAKOTACARE