MEDICARE: WHOLE PERSON HEALTH PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2983	NC

General Provider Information

NPI Number	:	1366623563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE PERSON HEALTH PC

Provider Business Mailing Address
First Line	:	3315 SPRINGBANK LN STE 304
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3198
Country	:	US
Telephone Number	:	704-837-2420
Fax Number	:	704-246-5193

Provider Business Practice Location Address
First Line	:	3315 SPRINGBANK LN STE 304
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3198
Country	:	US
Telephone Number	:	704-837-2420
Fax Number	:	704-246-5193

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KENNETH NELSON HAAS
Credential	:	D.C.
Telephone Number	:	704-837-2420

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

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