Provider Demographics
NPI:1922399062
Name:CARON, JOSEPH FREDERICK (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FREDERICK
Last Name:CARON
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 1:204 S BUCKEYE ST
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-3302
Mailing Address - Country:US
Mailing Address - Phone:620-363-1896
Mailing Address - Fax:
Practice Address - Street 1:204 S BUCKEYE ST
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3302
Practice Address - Country:US
Practice Address - Phone:620-363-1896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-24
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03803111N00000X
VT738111N00000X
NYX006183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor