Individual
AMY JACKSON CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2044 ENERGY DR, APEX, NC 27502-8722
(919) 780-1551
Mailing address
2044 ENERGY DR, APEX, NC 27502-8722
(919) 780-1551
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3967
NC
111N00000X
Chiropractor
7934
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2340526
MEDICARE GROUP
NC
05
—
5912257
—
NC
Enumeration date
10/30/2007
Last updated
12/29/2022
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