Provider Demographics
NPI:1942285150
Name:CARLETON, CAROLYN JOAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:JOAN
Last Name:CARLETON
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 1:4101 W PASADENA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-2838
Mailing Address - Country:US
Mailing Address - Phone:602-841-2524
Mailing Address - Fax:602-347-5570
Practice Address - Street 1:18700 N 107TH AVE
Practice Address - Street 2:STE 30
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85373-9734
Practice Address - Country:US
Practice Address - Phone:623-933-6590
Practice Address - Fax:623-933-6590
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ72624Medicare ID - Type Unspecified