Provider Demographics
NPI:1376879148
Name:CARLTON, PATRICIA T (PT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:T
Last Name:CARLTON
Suffix:
Gender:F
Credentials:PT
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Other - Last Name:
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Mailing Address - Street 1:342 VIRGINIA AVENUE
Mailing Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382
Mailing Address - Country:US
Mailing Address - Phone:276-228-6200
Mailing Address - Fax:276-228-9175
Practice Address - Street 1:104 N. SANDERS AVE
Practice Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA-CHILHOWIE
Practice Address - City:CHILHOWIE
Practice Address - State:VA
Practice Address - Zip Code:24319
Practice Address - Country:US
Practice Address - Phone:276-646-8774
Practice Address - Fax:276-646-5576
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305003195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist