Healthcare Provider Details

I. General information

NPI: 1891802708
Provider Name (Legal Business Name): CHIROPRACTIC CENTER OF PEMBROKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

401 E 3RD STREET
PEMBROKE NC
28372-3028
US

IV. Provider business mailing address

PO BOX 3028
PEMBROKE NC
28372-3028
US

V. Phone/Fax

Practice location:
  • Phone: 910-521-7800
  • Fax: 910-521-7893
Mailing address:
  • Phone: 910-521-7800
  • Fax: 910-521-7893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SHERWOOD F HINSON JR.
Title or Position: ADMINISTRATOR
Credential: D.C.
Phone: 910-521-7800