Provider Demographics
NPI:1942390588
Name:CARRIER CHIROPRACTIC P C
Entity Type:Organization
Organization Name:CARRIER CHIROPRACTIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-822-7421
Mailing Address - Street 1:129 INDIAN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3820
Mailing Address - Country:US
Mailing Address - Phone:615-822-7421
Mailing Address - Fax:615-822-7475
Practice Address - Street 1:129 INDIAN LAKE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3820
Practice Address - Country:US
Practice Address - Phone:615-822-7421
Practice Address - Fax:615-822-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN775111N00000X
TN774111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3979780OtherDRG CIGNA ID
TN4442119OtherDRG UHC ID
TN4318508OtherDRG BC ID
TN3036223OtherDRM BC ID
TN4318508OtherDRG AETNA ID
TN4671200OtherDRM AETNA ID
TN6713036OtherDRM AETNA ID
TN4442024OtherDRM UHC ID
TN4442024OtherDRM UHC ID
TN3735581Medicare PIN