Provider Demographics
NPI:1942400320
Name:CARRIER FAMILY CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:CARRIER FAMILY CHIROPRACTIC, P.A.
Other - Org Name:D.E. CARRIER D.C., INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLY
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:CARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-454-3043
Mailing Address - Street 1:2609 EASTLAND AVE.
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402
Mailing Address - Country:US
Mailing Address - Phone:903-454-3043
Mailing Address - Fax:903-455-0339
Practice Address - Street 1:2609 EASTLAND ST.
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402
Practice Address - Country:US
Practice Address - Phone:903-454-3043
Practice Address - Fax:903-455-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
TX7269111N00000X
TX10681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty