Healthcare Provider Details

I. General information

NPI: 1326068172
Provider Name (Legal Business Name): CARMELO F CARATOZZOLO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 HERITAGE DR
PALMYRA VA
22963-2662
US

IV. Provider business mailing address

68 HERITAGE DR
PALMYRA VA
22963-2662
US

V. Phone/Fax

Practice location:
  • Phone: 434-500-9890
  • Fax: 434-500-9880
Mailing address:
  • Phone: 434-500-9890
  • Fax: 434-500-9880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104001578
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: