MEDICARE: ADVANCED FAMILY CHIROPRACTIC CLINIC, PLLC

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	4116	NC

General Provider Information

NPI Number	:	1861791956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FAMILY CHIROPRACTIC CLINIC, PLLC

Provider Business Mailing Address
First Line	:	3137 AMITY COURT
Second Line	:	SUITE 100
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-5766
Country	:	US
Telephone Number	:	704-537-7778
Fax Number	:	704-537-7767

Provider Business Practice Location Address
First Line	:	3137 AMITY COURT
Second Line	:	SUITE 100
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-5766
Country	:	US
Telephone Number	:	704-537-7778
Fax Number	:	704-537-7767

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ERIC BATCHATIS
Credential	:	D.C.
Telephone Number	:	704-537-7778

Provider Enumeration Date	:	03/15/2011
Last Update Date	:	03/15/2011

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