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General NPI Number Information
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NPI Number | 1073654760
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Entity Type | Organization
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Legal Business Name | CAGLE CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 403 MAIN ST W
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City | AHOSKIE
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State | NC
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Zip | 27910-3321
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Country | US
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Telephone | 252-332-1990
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Fax | 252-332-7620
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Provider Business Mailing Address
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Address Line | PO BOX 823
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City | AHOSKIE
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State | NC
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Zip | 27910-0823
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Country | US
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Telephone | 252-332-1990
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Fax | 252-332-7620
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Authorized Official
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Title or Position | OWNER
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Name | DR. LARRY SHAWN CAGLE
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Credential | D.C.
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Telephone | 252-332-1990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 2075
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License Number State | NC
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