Healthcare Provider Details

I. General information

NPI: 1619630399
Provider Name (Legal Business Name): PERRY CARPENTER CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 BEAR ROCK ROAD
PLACERVILLE CA
95667
US

IV. Provider business mailing address

P.O. BOX 1507
PLACERVILLE CA
95667
US

V. Phone/Fax

Practice location:
  • Phone: 800-676-8127
  • Fax: 530-295-9196
Mailing address:
  • Phone: 800-676-8127
  • Fax: 530-295-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. PERRY J. CARPENTER
Title or Position: OWNER
Credential: D.C.
Phone: 800-676-8127