MEDICARE: DR. JUSTIN DICK DC

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	4741	NC

General Provider Information

NPI Number	:	1558871459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN DICK DC

Provider Business Mailing Address
First Line	:	10215 HICKORYWOOD HILL AVE STE C
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-3428
Country	:	US
Telephone Number	:	980-368-0766
Fax Number	:

Provider Business Practice Location Address
First Line	:	10215 HICKORYWOOD HILL AVE STE C
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-3428
Country	:	US
Telephone Number	:	980-368-0766
Fax Number	:	704-759-9020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	04/25/2023

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Directions to “ DR. JUSTIN DICK DC” Practice Location

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