Healthcare Provider Details

I. General information

NPI: 1871697557
Provider Name (Legal Business Name): ERIC JOSEPH BARONCIANI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 CHERRY ST
JONESVILLE NC
28642-2116
US

IV. Provider business mailing address

105 CHERRY ST
JONESVILLE NC
28642-2116
US

V. Phone/Fax

Practice location:
  • Phone: 336-835-1997
  • Fax: 336-835-1996
Mailing address:
  • Phone: 336-835-1997
  • Fax: 336-835-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2583
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: