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General NPI Number Information
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NPI Number | 1205320181
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Entity Type | Individual
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Provider Name | GLEN ROY CARKIN MD DC
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 18 MAIN ST STE 210
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City | TOWNSEND
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State | MA
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Zip | 01469-1300
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Country | US
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Telephone | 978-877-1536
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Fax |
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Provider Business Mailing Address
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Address Line | 219 TURNPIKE RD APT 2
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City | ASHBY
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State | MA
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Zip | 01431-1967
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Country | US
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Telephone | 978-877-1536
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3592
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License Number State | MA
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