Provider Demographics
NPI:1154329480
Name:CHARLTON, CATHERINE (DC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CHARLTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W62N263 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2736
Mailing Address - Country:US
Mailing Address - Phone:262-375-3100
Mailing Address - Fax:414-352-4755
Practice Address - Street 1:W62N263 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-2736
Practice Address - Country:US
Practice Address - Phone:262-375-3100
Practice Address - Fax:414-352-4755
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26693111N00000X
WI3677-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor