Provider Demographics
NPI:1619630399
Name:PERRY CARPENTER CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:PERRY CARPENTER CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:800-676-8127
Mailing Address - Street 1:P.O. BOX 1507
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:800-676-8127
Mailing Address - Fax:530-295-9196
Practice Address - Street 1:1995 BEAR ROCK ROAD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667
Practice Address - Country:US
Practice Address - Phone:800-676-8127
Practice Address - Fax:530-295-9196
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERRY CARPENTER CHIROPRACTIC CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty