Provider Demographics
NPI:1033289202
Name:CARR, DANIEL JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:CARR
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 1:112 WEST BUTLER STREET
Mailing Address - Street 2:PO BOX 672
Mailing Address - City:FORT RECOVERY
Mailing Address - State:OH
Mailing Address - Zip Code:45846-0672
Mailing Address - Country:US
Mailing Address - Phone:419-375-1808
Mailing Address - Fax:419-375-1709
Practice Address - Street 1:112 WEST BUTLER STREET
Practice Address - Street 2:
Practice Address - City:FORT RECOVERY
Practice Address - State:OH
Practice Address - Zip Code:45846-0672
Practice Address - Country:US
Practice Address - Phone:419-375-1808
Practice Address - Fax:419-375-1709
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2531013Medicaid
OH2531013Medicaid
OHU94882Medicare UPIN