Provider Demographics
NPI:1326178591
Name:CARLSTON, JOHN WOODWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WOODWARD
Last Name:CARLSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 E 13TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-1403
Mailing Address - Country:US
Mailing Address - Phone:316-303-1600
Mailing Address - Fax:
Practice Address - Street 1:1011 E 13TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-1403
Practice Address - Country:US
Practice Address - Phone:316-303-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS01-04439OtherSTATE LISCENSE NUMBER