Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 226300000X | Kinesiotherapist |
NPI | 1174190029 |
---|---|
Provider Name | Dr. Tony Carlton |
First Address | Lillington, NC 27546-6271 |
Second Address | Lillington, NC 27546-6271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2021 |
Last Update Date | 14/09/2021 |