Provider Demographics
NPI:1043480544
Name:CARR, MICHELLE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:CARR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WESTMARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-7371
Mailing Address - Country:US
Mailing Address - Phone:337-993-2277
Mailing Address - Fax:337-993-2228
Practice Address - Street 1:105 WESTMARK BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7371
Practice Address - Country:US
Practice Address - Phone:337-993-2277
Practice Address - Fax:337-993-2228
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4N036Medicare UPIN