Provider Demographics
NPI:1871674010
Name:CARLTON, PAOLA (DC)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:CARLTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8805 SUDLEY RD
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4740
Mailing Address - Country:US
Mailing Address - Phone:703-335-9149
Mailing Address - Fax:703-335-9004
Practice Address - Street 1:8805 SUDLEY RD
Practice Address - Street 2:SUITE 200A
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4740
Practice Address - Country:US
Practice Address - Phone:703-335-9149
Practice Address - Fax:703-335-9004
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC03495Medicare PIN