Healthcare Provider Details

I. General information

NPI: 1962440560
Provider Name (Legal Business Name): MAYLAND CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 ROAN RD SUITE A
SPRUCE PINE NC
28777-9273
US

IV. Provider business mailing address

1703 ROAN RD SUITE A
SPRUCE PINE NC
28777-9273
US

V. Phone/Fax

Practice location:
  • Phone: 828-766-5555
  • Fax: 828-766-5565
Mailing address:
  • Phone: 828-766-5555
  • Fax: 828-766-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3466
License Number StateNC

VIII. Authorized Official

Name: ADAM DONALD WHITE
Title or Position: OWNER
Credential: D.C.
Phone: 828-766-5555