Provider Demographics
NPI:1528274677
Name:CARMER, TODD MICHEAL (DC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:MICHEAL
Last Name:CARMER
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:PO BOX 4353
Mailing Address - Street 2:115 EAST 2ND STREET
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-4353
Mailing Address - Country:US
Mailing Address - Phone:970-328-2225
Mailing Address - Fax:970-328-2235
Practice Address - Street 1:115 EAST 2ND STREET
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-4353
Practice Address - Country:US
Practice Address - Phone:970-328-2225
Practice Address - Fax:970-328-2235
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02-0613068Medicare UPIN