Healthcare Provider Details

I. General information

NPI: 1902732142
Provider Name (Legal Business Name): INTENTION CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 JOHNSTON RD STE NO112
CHARLOTTE NC
28226-4558
US

IV. Provider business mailing address

10801 JOHNSTON RD STE NO112
CHARLOTTE NC
28226-4558
US

V. Phone/Fax

Practice location:
  • Phone: 980-207-0557
  • Fax:
Mailing address:
  • Phone: 980-207-0557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CAELAN JONES
Title or Position: OWNER
Credential: DC
Phone: 980-207-0557