=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003118431
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GENTLE FAMILY CHIROPRACTIC CENTER, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2010
-----------------------------------------------------
Last Update Date | 11/17/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 82 ARLINGTON ST
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-2032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-253-8900
-----------------------------------------------------
Fax | 828-505-1974
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 82 ARLINGTON ST
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-2032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-253-8900
-----------------------------------------------------
Fax | 828-505-1974
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPERATOR
-----------------------------------------------------
Name | DR. MATILDA SIENKO
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 828-253-8900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1822
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------