Provider Demographics
NPI:1184821100
Name:CARLTON CHIROPRACTICE & MASSAGE INC
Entity Type:Organization
Organization Name:CARLTON CHIROPRACTICE & MASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALENA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-798-3900
Mailing Address - Street 1:6404 MANATEE AVE W
Mailing Address - Street 2:SUITE J
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2379
Mailing Address - Country:US
Mailing Address - Phone:941-798-3900
Mailing Address - Fax:941-798-3939
Practice Address - Street 1:6404 MANATEE AVE W
Practice Address - Street 2:SUITE J
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2379
Practice Address - Country:US
Practice Address - Phone:941-798-3900
Practice Address - Fax:941-798-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
FL=========OtherTAX ID