Healthcare Provider Details

I. General information

NPI: 1609898782
Provider Name (Legal Business Name): MARS HILL CHIROPRACTIC CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 CARL ELLER RD.
MARS HILL NC
28754
US

IV. Provider business mailing address

PO BOX 1990
MARS HILL NC
28754-1990
US

V. Phone/Fax

Practice location:
  • Phone: 828-689-3777
  • Fax: 828-678-5435
Mailing address:
  • Phone: 828-689-3777
  • Fax: 828-689-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberNC1419
License Number StateNC

VIII. Authorized Official

Name: DR. STEPHEN CANNER
Title or Position: OWNER
Credential: DC
Phone: 828-689-3777