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General NPI Number Information
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NPI Number | 1093892077
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Entity Type | Organization
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Legal Business Name | GREGORY CHIROPRACTIC CENTER PA
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 611 N CENTRAL AVE
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City | BELMONT
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State | NC
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Zip | 28012-3151
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Country | US
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Telephone | 704-829-9200
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Fax | 704-829-5700
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Provider Business Mailing Address
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Address Line | 611 N CENTRAL AVE
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City | BELMONT
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State | NC
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Zip | 28012-3151
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Country | US
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Telephone | 704-829-9200
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Fax | 704-829-5700
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW GREGORY
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Credential |
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Telephone | 704-829-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 2333
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License Number State | NC
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