Healthcare Provider Details

I. General information

NPI: 1982887238
Provider Name (Legal Business Name): LINDSEY MARIE HATTERSLEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6580 OLD MONROE RD SUITE A
INDIAN TRAIL NC
28079-5361
US

IV. Provider business mailing address

6580 OLD MONROE RD SUITE A
INDIAN TRAIL NC
28079-5361
US

V. Phone/Fax

Practice location:
  • Phone: 704-225-8686
  • Fax: 704-225-9988
Mailing address:
  • Phone: 704-225-8686
  • Fax: 704-225-9988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3804
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: