Provider Demographics
NPI:1205929031
Name:CHARLTON, KAREN M (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:CHARLTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 N POLK ST
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-8563
Mailing Address - Country:US
Mailing Address - Phone:704-889-7828
Mailing Address - Fax:704-889-7832
Practice Address - Street 1:561 N POLK ST
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-8563
Practice Address - Country:US
Practice Address - Phone:704-889-7828
Practice Address - Fax:704-889-7832
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2166225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist