Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34476 | CA |
NPI | 1003376633 |
---|---|
Provider Name | Dr. Jaelee Carlton |
First Address | Long Beach, CA 90803-4841 |
Second Address | Long Beach, CA 90803-4841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2019 |
Last Update Date | 20/03/2019 |