Provider Demographics
NPI:1811333487
Name:CARLTON, EVE NGOC (PTA)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:NGOC
Last Name:CARLTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 HRUSKA BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1793
Mailing Address - Country:US
Mailing Address - Phone:402-812-9571
Mailing Address - Fax:
Practice Address - Street 1:4835 S 49TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68117-2002
Practice Address - Country:US
Practice Address - Phone:402-733-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1029225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant