Provider Demographics
NPI:1033357140
Name:CARLISLE, CHRIS ALLEN (CSFA)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:ALLEN
Last Name:CARLISLE
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-0215
Mailing Address - Country:US
Mailing Address - Phone:303-814-1339
Mailing Address - Fax:720-389-6158
Practice Address - Street 1:7720 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2632
Practice Address - Country:US
Practice Address - Phone:303-814-1339
Practice Address - Fax:720-389-6158
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
96972246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant