Provider Demographics
NPI:1033612536
Name:CARLTON, CALYN (DPT)
Entity Type:Individual
Prefix:
First Name:CALYN
Middle Name:
Last Name:CARLTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CALYN
Other - Middle Name:
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 W LIME AVE APT B
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-5749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1902
Practice Address - Country:US
Practice Address - Phone:626-967-7833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT294480225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist