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General NPI Number Information
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NPI Number | 1093884140
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Entity Type | Organization
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Legal Business Name | ADVANCE WELLNESS CHIROPRACTIC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 604 PASTEUR DR STE B
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City | GREENSBORO
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State | NC
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Zip | 27403-1145
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Country | US
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Telephone | 336-316-0827
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Fax | 336-316-0828
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Provider Business Mailing Address
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Address Line | 604 PASTEUR DR STE B
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City | GREENSBORO
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State | NC
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Zip | 27403-1145
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Country | US
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Telephone | 336-316-0827
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Fax | 336-316-0828
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | JOSEPH COLLINS DRAPER III
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Credential |
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Telephone | 336-316-0827
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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 | 2903
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License Number State | NC
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