Healthcare Provider Details

I. General information

NPI: 1568543460
Provider Name (Legal Business Name): JAMES FLOYD LITAKER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5403 VILLAGE DR
CONCORD NC
28027-5334
US

IV. Provider business mailing address

4949 PROFESSIONAL PARK DR STE 206
KANNAPOLIS NC
28081-8638
US

V. Phone/Fax

Practice location:
  • Phone: 704-467-4808
  • Fax:
Mailing address:
  • Phone: 704-467-4808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1031
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: