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General NPI Number Information
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NPI Number | 1083587000
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Entity Type | Organization
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Legal Business Name | KEITH CLINIC ESTRAMONTE CHIROPRACTIC KINGS MOUNTAIN PA
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 510A W KING ST
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-3310
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Country | US
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Telephone | 980-396-2811
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Fax |
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Provider Business Mailing Address
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Address Line | 510A W KING ST STE A
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-3310
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Country | US
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Telephone | 980-396-2811
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Fax | 980-221-1654
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Authorized Official
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Title or Position | SENIOR ACCOUNTING ANALYST
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Name | DEBRA LEE HUDSON
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Credential |
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Telephone | 704-420-4690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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