=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114076221
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARRON PERRY D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2007
-----------------------------------------------------
Last Update Date | 12/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2785 WHITE BEAR AVE N STE 107
-----------------------------------------------------
City | MAPLEWOOD
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55109-1320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-398-0243
-----------------------------------------------------
Fax | 651-560-3911
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2454 RIPLEY AVE
-----------------------------------------------------
City | NORTH SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55109-4905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-398-0243
-----------------------------------------------------
Fax | 651-560-3911
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NX0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Chiropractor
-----------------------------------------------------
License Number | 4080
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------