Healthcare Provider Details

I. General information

NPI: 1396767299
Provider Name (Legal Business Name): GEORGE ALEXANDER LIMBANOVNOS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 WEDDINGTON RD
WEDDINGTON NC
28104-8318
US

IV. Provider business mailing address

1934 WEDDINGTON RD
WEDDINGTON NC
28104-8318
US

V. Phone/Fax

Practice location:
  • Phone: 704-321-0656
  • Fax: 704-321-0092
Mailing address:
  • Phone: 704-321-0656
  • Fax: 704-321-0092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2716
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: