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Individual

BRAD GLENN CARROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2045 S JACKSON ST, JACKSONVILLE, TX 75766-5821
(903) 586-3667
(903) 586-6404
Mailing address
212 WALNUT CIR, JACKSONVILLE, TX 75766-0560
(469) 576-2664
(903) 586-6404

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5324
TX

Other

Enumeration date
12/18/2012
Last updated
12/18/2012
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