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General NPI Number Information
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NPI Number | 1093765984
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Entity Type | Organization
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Legal Business Name | PAYNE CHIROPRACTIC CENTER PA
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 215 W BROAD ST
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City | STATESVILLE
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State | NC
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Zip | 28677-5259
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Country | US
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Telephone | 704-838-0990
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Fax | 704-838-0678
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Provider Business Mailing Address
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Address Line | 215 W BROAD ST
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City | STATESVILLE
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State | NC
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Zip | 28677-5259
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Country | US
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Telephone | 704-838-0990
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Fax | 704-838-0678
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JEFFREY E PAYNE
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Credential | DC
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Telephone | 704-838-0990
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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 | 1997
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License Number State | NC
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