Provider Demographics
NPI:1346883568
Name:NEWTON, CARL (ATC)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:
Last Name:NEWTON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 W BADDOUR PKWY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2513
Mailing Address - Country:US
Mailing Address - Phone:615-443-6099
Mailing Address - Fax:615-443-6094
Practice Address - Street 1:9360 SPARTA PIKE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:TN
Practice Address - Zip Code:37184-1428
Practice Address - Country:US
Practice Address - Phone:615-237-3434
Practice Address - Fax:615-237-3030
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer