Healthcare Provider Details

I. General information

NPI: 1073609665
Provider Name (Legal Business Name): GRAYBAR CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 N NORWOOD ST
WALLACE NC
28466-2730
US

IV. Provider business mailing address

PO BOX 15033
WILMINGTON NC
28408-5033
US

V. Phone/Fax

Practice location:
  • Phone: 910-285-7222
  • Fax: 910-285-7229
Mailing address:
  • Phone: 910-285-7222
  • Fax: 910-285-7229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CRYSTAL WARD
Title or Position: OFFICE MANAGER
Credential:
Phone: 910-285-7222