Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1457 | CO |
N | 111NN1001X | Nutrition | 1457 | CO |
NPI | 1225115587 |
---|---|
Provider Name | Dr. Edward E. Carr |
First Address | Fort Collins, CO 80525-2216 |
Second Address | Fort Collins, CO 80525-2216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 09/02/2010 |