Healthcare Provider Details

I. General information

NPI: 1205741741
Provider Name (Legal Business Name): RESTORE CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6112 LANGWELL LN
CHARLOTTE NC
28278
US

IV. Provider business mailing address

1914 J N PEASE PL STE 151
CHARLOTTE NC
28262-4504
US

V. Phone/Fax

Practice location:
  • Phone: 704-641-1015
  • Fax:
Mailing address:
  • Phone: 704-641-1015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. HECTOR RAUL MERA MENDIETA
Title or Position: OWNER
Credential: DC
Phone: 704-641-1015