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General NPI Number Information
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NPI Number | 1477734135
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Entity Type | Organization
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Legal Business Name | CARB CC TWO LLC
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 267 BROOKLYN STREET SUITE A
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City | CARBONDALE
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State | PA
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Zip | 18407-2829
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Country | US
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Telephone | 570-282-1240
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Fax | 570-282-7937
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Provider Business Mailing Address
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Address Line | 267 BROOKLYN STREET SUITE A
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City | CARBONDALE
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State | PA
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Zip | 18407-2829
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Country | US
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Telephone | 570-282-1240
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Fax | 570-282-7937
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH W MERLI
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Credential | D.C.
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Telephone | 570-282-1240
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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 | DC004100L
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License Number State | PA
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