Healthcare Provider Details

I. General information

NPI: 1225255151
Provider Name (Legal Business Name): DR. LIDIA SANDA ADKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LIDIA SANDA ADKINS D.C.

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1846 E FRANKLIN BLVD
GASTONIA NC
28054-4751
US

IV. Provider business mailing address

1846 E FRANKLIN BLVD
GASTONIA NC
28054-4751
US

V. Phone/Fax

Practice location:
  • Phone: 704-864-0356
  • Fax: 704-864-0858
Mailing address:
  • Phone: 704-864-0356
  • Fax: 704-864-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3680
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: