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Individual

DR. THOMAS EDWARD CARLYLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
611 COURT ST, SUITE 4, CONWAY, AR 72032-5446
(501) 358-4894
(501) 358-4891
Mailing address
611 COURT ST, SUITE 4, CONWAY, AR 72032-5446
(501) 358-4894
(501) 358-4891

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1569
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142756718
AR
01
21462
MEDICARE PTAN
WY
Enumeration date
02/15/2006
Last updated
07/08/2008
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