Healthcare Provider Details

I. General information

NPI: 1154707453
Provider Name (Legal Business Name): DR MICHAEL S TRAYFORD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WALDEN RIDGE DR SUITE 80
ASHEVILLE NC
28803-8597
US

IV. Provider business mailing address

2 WALDEN RIDGE DR SUITE 80
ASHEVILLE NC
28803-8597
US

V. Phone/Fax

Practice location:
  • Phone: 828-708-5274
  • Fax: 866-447-7164
Mailing address:
  • Phone: 828-708-5274
  • Fax: 866-447-7164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number3403
License Number StateNC

VIII. Authorized Official

Name: DR. MICHAEL S TRAYFORD
Title or Position: OWNER
Credential: DC
Phone: 828-708-5274