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Contact Information

30 CHIROPRACTIC
616 INDIAN TRAIL RD S
INDIAN TRAIL, NC28079-9680
 Phone: 704-821-5000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for 30 CHIROPRACTIC · (Female)

NPI # 1992063861
Status Active
Credentials
Entity Individual
Enumeration date 04/30/2012
Last updated 04/30/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC License # 3197
  • NC Medicaid 5900344
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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