Healthcare Provider Details

I. General information

NPI: 1598629636
Provider Name (Legal Business Name): CARLEIGH ANNE WALTERS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 S LOGAN BLVD STE 3
ALTOONA PA
16602-5654
US

IV. Provider business mailing address

6646 S CARACOL CV
SALT LAKE CITY UT
84121-3458
US

V. Phone/Fax

Practice location:
  • Phone: 814-296-2222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC012089
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: