Healthcare Provider Details

I. General information

NPI: 1710049515
Provider Name (Legal Business Name): HOLLY SPRINGS CHIROPRACTIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HOLLY SPRINGS RD
HOLLY SPRINGS NC
27540-9423
US

IV. Provider business mailing address

125 HOLLY SPRINGS RD
HOLLY SPRINGS NC
27540-9423
US

V. Phone/Fax

Practice location:
  • Phone: 919-552-8011
  • Fax: 919-557-1285
Mailing address:
  • Phone: 919-552-8011
  • Fax: 919-557-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number3160
License Number StateNC

VIII. Authorized Official

Name: DR. RANDALL SCOTT ADAMSON
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 919-552-8011