Provider Demographics
NPI:1508813676
Name:CARLTON, RYAN J (DC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:J
Last Name:CARLTON
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 1:6430 US ROUTE 60 E
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1240
Mailing Address - Country:US
Mailing Address - Phone:304-736-4111
Mailing Address - Fax:304-736-0334
Practice Address - Street 1:6007 US ROUTE 60 E STE 120
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1046
Practice Address - Country:US
Practice Address - Phone:304-736-1653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2201017000Medicaid
WV4036781Medicare ID - Type UnspecifiedMEDICARE NUMBER
WA2201017000Medicaid