Healthcare Provider Details

I. General information

NPI: 1033289202
Provider Name (Legal Business Name): DANIEL JOSEPH CARR D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 WEST BUTLER STREET
FORT RECOVERY OH
45846-0672
US

IV. Provider business mailing address

112 WEST BUTLER STREET PO BOX 672
FORT RECOVERY OH
45846-0672
US

V. Phone/Fax

Practice location:
  • Phone: 419-375-1808
  • Fax: 419-375-1709
Mailing address:
  • Phone: 419-375-1808
  • Fax: 419-375-1709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3511
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: