Provider Demographics
NPI:1871170712
Name:CARLTON, DARCIE (LAC)
Entity type:Individual
Prefix:
First Name:DARCIE
Middle Name:
Last Name:CARLTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 WHISPERING HILL DR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-8818
Mailing Address - Country:US
Mailing Address - Phone:847-529-9576
Mailing Address - Fax:
Practice Address - Street 1:1004 STATE ST
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4881
Practice Address - Country:US
Practice Address - Phone:563-265-5099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist