Provider Demographics
NPI:1902980212
Name:CARRANO, JOE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:CARRANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WATERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-6015
Mailing Address - Country:US
Mailing Address - Phone:864-509-8640
Mailing Address - Fax:
Practice Address - Street 1:2520 WADE HAMPTON BLVD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-1148
Practice Address - Country:US
Practice Address - Phone:864-552-1142
Practice Address - Fax:864-552-1143
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC002535111N00000X
SC2535111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2535Medicaid
SCCH2535Medicaid