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NPI Code Detail

MEDICARE: SOUTHERN PINES CHIROPRACTIC, P.A.

MEDICARE: SOUTHERN PINES CHIROPRACTIC, P.A.
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
1225700000XMassage Therapist
2111N00000XChiropractor1784NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
208919OTHERNCBCBS

General Provider Information

NPI Number : 1427154566
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN PINES CHIROPRACTIC, P.A.
Provider Business Mailing Address
First Line : 361 N BENNETT ST
Second Line :
City : SOUTHERN PINES
State : NC
Zip : 28387-4812
Country : US
Telephone Number : 910-692-5207
Fax Number : 910-692-4487
Provider Business Practice Location Address
First Line : 361 N BENNETT ST
Second Line :
City : SOUTHERN PINES
State : NC
Zip : 28387-4812
Country : US
Telephone Number : 910-692-5207
Fax Number : 910-692-4487
Authorized Official
Title or Position : VICE PRESIDENT
Name : MS. CELIA COOK WAHL
Credential : OFFICE MANAGER
Telephone Number : 910-692-5207
Provider Enumeration Date : 09/16/2006
Last Update Date : 10/03/2025

Similar Medicare Providers

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Practice Location Address:
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SOUTHERN PINES, NC
28387-4812
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Practice Fax: 910-692-4498
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Directions to “SOUTHERN PINES CHIROPRACTIC, P.A. ” Practice Location

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