Healthcare Provider Details

I. General information

NPI: 1538463542
Provider Name (Legal Business Name): GARD CHIROPRACTIC & ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 KILDAIRE FARM RD
CARY NC
27511-5525
US

IV. Provider business mailing address

1133 STURDIVANT DR
CARY NC
27511-4749
US

V. Phone/Fax

Practice location:
  • Phone: 919-397-3220
  • Fax:
Mailing address:
  • Phone: 919-397-3220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4123
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number4124
License Number StateNC

VIII. Authorized Official

Name: DR. ALIYA M GARD
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 919-397-3220