Individual
DR. DEANNA CARLISLE ATHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
152 N HARBOR CITY BLVD STE 100, MELBOURNE, FL 32935-6794
(321) 255-0010
(321) 255-0044
Mailing address
152 N HARBOR CITY BLVD STE 100, MELBOURNE, FL 32935-6794
(321) 255-0010
(321) 255-0044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0007519
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659597623
GROUP NPI
—
01
—
350050517
RAILROAD MEDICARE
FL
01
—
55726
BC/BS
FL
01
—
AB872
MEDICARE GROUP NO.
—
Enumeration date
09/24/2006
Last updated
03/06/2018
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