Individual
CARLIE STAFFORD CARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 HOMESTEAD HILLS DR, WINSTON SALEM, NC 27103-6445
(336) 744-8942
Mailing address
2101 HOMESTEAD HILLS DR, WINSTON SALEM, NC 27103-6445
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A6581
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A6581
LICENSE NUMBER
NC
Enumeration date
06/25/2020
Last updated
07/02/2020
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