Provider Demographics
NPI:1851606511
Name:CHILTON, ANTHONY RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RYAN
Last Name:CHILTON
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 1:811 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2462
Mailing Address - Country:US
Mailing Address - Phone:360-423-3482
Mailing Address - Fax:360-425-6264
Practice Address - Street 1:811 11TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2462
Practice Address - Country:US
Practice Address - Phone:360-423-3482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60171324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor