Provider Demographics
NPI:1982704177
Name:CARROLL, MILTON LEMMON (DC)
Entity Type:Individual
Prefix:DR
First Name:MILTON
Middle Name:LEMMON
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 1:675 S 100 W STE 4
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2883
Mailing Address - Country:US
Mailing Address - Phone:801-465-8177
Mailing Address - Fax:801-465-8266
Practice Address - Street 1:675 S 100 W STE 4
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2883
Practice Address - Country:US
Practice Address - Phone:801-465-8177
Practice Address - Fax:801-465-8266
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5163725-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor