Healthcare Provider Details

I. General information

NPI: 1588741631
Provider Name (Legal Business Name): RUTHERFORD COUNTY CHIROPRACTIC CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 ALLENDALE DR
FOREST CITY NC
28043-2874
US

IV. Provider business mailing address

134 ALLENDALE DR
FOREST CITY NC
28043-2874
US

V. Phone/Fax

Practice location:
  • Phone: 828-245-2442
  • Fax: 828-245-2772
Mailing address:
  • Phone: 828-245-2442
  • Fax: 828-245-2772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2037
License Number StateNC

VIII. Authorized Official

Name: CHRISTIAN DONALD BURLEY
Title or Position: PRESIDENT/CHIROPRACTOR
Credential: D.C., F.A.C.O.
Phone: 828-245-2442