Healthcare Provider Details

I. General information

NPI: 1104780394
Provider Name (Legal Business Name): CAROLINA CHIROPRACTIC GROUP UNIVERSITY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8821 UNIVERSITY EAST DR
CHARLOTTE NC
28213-4200
US

IV. Provider business mailing address

145 W DIXON BLVD
SHELBY NC
28152-6546
US

V. Phone/Fax

Practice location:
  • Phone: 704-428-9006
  • Fax: 704-710-8037
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY MOFFITT
Title or Position: OWNER/DOCTOR
Credential: DC
Phone: 704-428-9006