MEDICARE: DANIEL J CARR D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC007787L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00073539	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	795327	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1982791638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL J CARR D.C.

Provider Business Mailing Address
First Line	:	1309 BUCKTAIL RD
Second Line	:
City	:	SAINT MARYS
State	:	PA
Zip	:	15857-3264
Country	:	US
Telephone Number	:	814-834-1134
Fax Number	:

Provider Business Practice Location Address
First Line	:	1309 BUCKTAIL RD
Second Line	:
City	:	SAINT MARYS
State	:	PA
Zip	:	15857-3264
Country	:	US
Telephone Number	:	814-834-1134
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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