Provider Demographics
NPI:1336335025
Name:CARLTON, RAYMOND SCOTT (PT)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:SCOTT
Last Name:CARLTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 MOHAVE DR
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-4797
Mailing Address - Country:US
Mailing Address - Phone:530-662-9161
Mailing Address - Fax:
Practice Address - Street 1:1312 HARLEY DR
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4430
Practice Address - Country:US
Practice Address - Phone:530-662-9161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist