Provider Demographics
NPI:1700802592
Name:CARR, LOUIS S (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:S
Last Name:CARR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4745
Mailing Address - Country:US
Mailing Address - Phone:801-225-3481
Mailing Address - Fax:801-225-3482
Practice Address - Street 1:207 N STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4745
Practice Address - Country:US
Practice Address - Phone:801-225-3481
Practice Address - Fax:801-225-3482
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT164778-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT873365OtherFIRST HEALTH
UT005598501Medicare ID - Type Unspecified
UT873365OtherFIRST HEALTH