Provider Demographics
NPI:1467583948
Name:CARLISLE CHIROPRACTIC CLINIC EAST
Entity Type:Organization
Organization Name:CARLISLE CHIROPRACTIC CLINIC EAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR- PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:CARLISLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-525-0026
Mailing Address - Street 1:3130 MONROE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-7538
Mailing Address - Country:US
Mailing Address - Phone:704-338-1900
Mailing Address - Fax:704-333-1632
Practice Address - Street 1:3130 MONROE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-7538
Practice Address - Country:US
Practice Address - Phone:704-338-1900
Practice Address - Fax:704-333-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012H4OtherBCBS
NC89012H4Medicaid
NC2456548Medicare ID - Type Unspecified