Provider Demographics
NPI:1750360376
Name:CARROLL, DAVID F (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:CARROLL
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 1:470 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:781-769-2728
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:781-769-2728
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1096111NS0005X, 111NI0013X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35774Medicare PIN