Healthcare Provider Details

I. General information

NPI: 1871609750
Provider Name (Legal Business Name): NELSON & NELSON VI, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 RAEFORD RD SUITE 101
FAYETTEVILLE NC
28304-3053
US

IV. Provider business mailing address

6021 RAEFORD RD SUITE 101
FAYETTEVILLE NC
28304-3053
US

V. Phone/Fax

Practice location:
  • Phone: 910-860-5559
  • Fax: 910-860-1165
Mailing address:
  • Phone: 910-860-5559
  • Fax: 910-860-1165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2169
License Number StateNC

VIII. Authorized Official

Name: DR. GARRY NELSON
Title or Position: PRESIDENT
Credential: D.C.
Phone: 910-964-2070