Healthcare Provider Details

I. General information

NPI: 1518822253
Provider Name (Legal Business Name): BLITZ CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 WILLIAMSON RD STE 411
MOORESVILLE NC
28117-9227
US

IV. Provider business mailing address

514 WILLIAMSON RD STE 411
MOORESVILLE NC
28117-9227
US

V. Phone/Fax

Practice location:
  • Phone: 704-728-7072
  • Fax:
Mailing address:
  • Phone: 704-728-7072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MAXWELL BLITSTEIN
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 704-728-7072