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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

NPI Number 1992063861
LBN Legal business name 30 CHIROPRACTIC
Authorized official JOHN MONBARREN - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/30/2012
Last updated 04/30/2012 - About 14 years ago
Identifiers
NC License # 3197
NC Medicaid 5900344
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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