Healthcare Provider Details

I. General information

NPI: 1962483529
Provider Name (Legal Business Name): SUMMERFIELD FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4523 US HIGHWAY 220 N
SUMMERFIELD NC
27358-9412
US

IV. Provider business mailing address

4523 US HIGHWAY 220 N PO BOX 683
SUMMERFIELD NC
27358-9412
US

V. Phone/Fax

Practice location:
  • Phone: 336-644-1112
  • Fax: 336-644-1118
Mailing address:
  • Phone: 336-644-1112
  • Fax: 336-644-1118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2482
License Number StateNC

VIII. Authorized Official

Name: DR. ROD C BROWN
Title or Position: CHIROPRACTOR/PRESIDENT
Credential: D.C.
Phone: 336-644-1112