| Doctor Name: | DR. JACKIE LEE CAROLUS |
| NPI Number: | 1144527557 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.C. |
| License Number: | 5355 |
| Business Practice Address: | 403 1st Ave Perry, IA - 502201902 |
| Business Phone Number: | 5154653585 |
| Business Fax Number: | 5154654651 |
| Mailing Address: | Po Box 592442, SAN ANTONIO |
| State: | TX |
| Postal Code: | 782590172 |
| Phone Number: | 5154940966 |
| Fax Number: | |
| NPI Enumeration Date: | 02/21/2011 |
| NPI Last Update Date: | 05/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 5355 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |