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General NPI Number Information
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NPI Number | 1104780394
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Entity Type | Organization
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Legal Business Name | CAROLINA CHIROPRACTIC GROUP UNIVERSITY PLLC
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 8821 UNIVERSITY EAST DR
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City | CHARLOTTE
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State | NC
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Zip | 28213-4200
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Country | US
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Telephone | 704-428-9006
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Fax | 704-710-8037
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Provider Business Mailing Address
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Address Line | 145 W DIXON BLVD
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City | SHELBY
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State | NC
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Zip | 28152-6546
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | BRADLEY MOFFITT
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Credential | DC
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Telephone | 704-428-9006
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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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