Provider Demographics
NPI:1265542807
Name:DAVID F. CARROLL. D.C.,P.C.
Entity type:Organization
Organization Name:DAVID F. CARROLL. D.C.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-762-6153
Mailing Address - Street 1:470 WASHINGTON ST
Mailing Address - Street 2:UNIT 31
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-2337
Mailing Address - Country:US
Mailing Address - Phone:781-762-6153
Mailing Address - Fax:
Practice Address - Street 1:470 WASHINGTON ST
Practice Address - Street 2:UNIT 31
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2337
Practice Address - Country:US
Practice Address - Phone:781-762-6153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0006400Medicare PIN