Basic Information
| Provider Information | |||||||||
| NPI: | 1407021843 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARLTON | ||||||||
| FirstName: | TINA | ||||||||
| MiddleName: | ADAMS | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LPTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1729 30TH AVENUE DR NE | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286019072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282341972 | ||||||||
| FaxNumber: | 8283229068 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 HARRILSON RD | ||||||||
| Address2: | |||||||||
| City: | CHERRYVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280219541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044354161 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2008 | ||||||||
| LastUpdateDate: | 04/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 1436 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.