Provider Demographics
NPI:1730165606
Name:SALMON, CARL KIRT (DC)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:KIRT
Last Name:SALMON
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 1:10353 CORBEIL DR APT B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5940
Mailing Address - Country:US
Mailing Address - Phone:435-705-4293
Mailing Address - Fax:
Practice Address - Street 1:10353 CORBEIL DR APT B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5940
Practice Address - Country:US
Practice Address - Phone:435-705-4293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2725621202111NN0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU48331Medicare UPIN