MEDICARE: DR. HERBERT LEE FERRELL D.C.

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	3990	NC

General Provider Information

NPI Number	:	1881826873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT LEE FERRELL D.C.

Provider Business Mailing Address
First Line	:	6101 IDLEWILD RD
Second Line	:	SUITE 328
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-0517
Country	:	US
Telephone Number	:	704-295-1399
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 IDLEWILD RD
Second Line	:	SUITE 328
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-0517
Country	:	US
Telephone Number	:	704-295-1399
Fax Number	:

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

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	02/01/2012

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