| Organization Name: | CHARLES L. CARR JR, DO, PA |
| NPI Number: | 1346596483 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES L. CARR (PROVIDER/PRESIDENT/OWNER) |
| Mailing Address: | 2 Main Street Suite 404 Lafayette Center Kennebunk |
| State: | ME US |
| Postal Code: | 04043 |
| Phone Number: | 2079850011 |
| Fax Number: | 2079855111 |
| NPI Enumeration Date: | 07/26/2012 |
| NPI Last Update Date: | 07/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 1555 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |