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Individual

DR. ANTHONY A DECARLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
164 LONDON SHOPPING CENTER, LONDON, KY 40741
(606) 864-3595
(606) 878-5499
Mailing address
164 LONDON SHOPPING CENTER, LONDON, KY 40741
(606) 864-3595
(606) 878-5499

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4169
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000041618
ANTHEM BC/BS
KY
01
350040041
MEDICARE RAILROAD
KY
05
85036523
KY
Enumeration date
10/02/2006
Last updated
07/08/2007
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