Provider Demographics
NPI:1609015106
Name:WALTON, CHARLES FOSTER (DC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:FOSTER
Last Name:WALTON
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 1:1622 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-5856
Mailing Address - Country:US
Mailing Address - Phone:561-588-0067
Mailing Address - Fax:561-588-0106
Practice Address - Street 1:1622 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-5856
Practice Address - Country:US
Practice Address - Phone:561-588-0067
Practice Address - Fax:561-588-0106
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8650111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor