Healthcare Provider Details

I. General information

NPI: 1366548984
Provider Name (Legal Business Name): THOMAS R. AYRES, DC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6837 FALLS OF NEUSE RD SUITE 106
RALEIGH NC
27615-5308
US

IV. Provider business mailing address

6837 FALLS OF NEUSE RD SUITE 106
RALEIGH NC
27615-5308
US

V. Phone/Fax

Practice location:
  • Phone: 919-846-0100
  • Fax: 919-846-3695
Mailing address:
  • Phone: 919-846-0100
  • Fax: 919-846-3695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1566
License Number StateNC

VIII. Authorized Official

Name: DR. THOMAS ROBERT AYRES
Title or Position: PRESIDENT
Credential: DC
Phone: 919-846-0100