Healthcare Provider Details

I. General information

NPI: 1598080103
Provider Name (Legal Business Name): SUSAN D OSADA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 1/2 EAGLE ST SUITE G
ASHEVILLE NC
28801-3794
US

IV. Provider business mailing address

312 UNION ST S
CONCORD NC
28025-5018
US

V. Phone/Fax

Practice location:
  • Phone: 828-301-2383
  • Fax:
Mailing address:
  • Phone: 828-301-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2501
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: