Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 4080 | MN |
NPI | 1114076221 |
---|---|
Provider Name | Dr. Carron Perry |
First Address | Saint Paul, MN 55105-2565 |
Second Address | Saint Paul, MN 55105-2229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 24/04/2020 |