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General NPI Number Information
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NPI Number | 1093454076
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Entity Type | Organization
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Legal Business Name | VITAL CHIROPRACTIC RENEWAL
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 1101 N MAIN ST
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City | WAYNESVILLE
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State | NC
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Zip | 28786-3593
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Country | US
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Telephone | 828-200-2191
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Fax |
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Provider Business Mailing Address
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Address Line | 342 MONTEITH BRANCH RD
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City | SYLVA
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State | NC
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Zip | 28779-9798
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Country | US
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Telephone | 828-200-2191
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DAKOTA PARRIS
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Credential | DC
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Telephone | 828-736-0326
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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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