Provider Demographics
NPI:1942432166
Name:DR. BRETT M. CARR, LLC
Entity Type:Organization
Organization Name:DR. BRETT M. CARR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-256-9971
Mailing Address - Street 1:1700 POST RD STE C16
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5726
Mailing Address - Country:US
Mailing Address - Phone:203-256-9971
Mailing Address - Fax:203-255-2182
Practice Address - Street 1:1700 POST RD STE C16
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5726
Practice Address - Country:US
Practice Address - Phone:203-256-9971
Practice Address - Fax:203-255-2182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0320111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350001034Medicare UPIN