Provider Demographics
NPI:1396085312
Name:CARROLL CHIROPRACTIC CLINIC, P. C.
Entity type:Organization
Organization Name:CARROLL CHIROPRACTIC CLINIC, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-432-5617
Mailing Address - Street 1:2021 N SLAPPEY BLVD
Mailing Address - Street 2:PMB 143
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1001
Mailing Address - Country:US
Mailing Address - Phone:229-432-5617
Mailing Address - Fax:229-883-0108
Practice Address - Street 1:1108 WHISPERING PINES RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3542
Practice Address - Country:US
Practice Address - Phone:229-432-5617
Practice Address - Fax:229-883-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center