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General NPI Number Information
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NPI Number | 1154427318
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Entity Type | Organization
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Legal Business Name | GARY P DACKOR DC INC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 1701 NORTH SANDHILLS BLVD. SUITE D
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City | ABERDEEN
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State | NC
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Zip | 28315
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Country | US
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Telephone | 910-944-7889
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Fax | 910-944-0899
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Provider Business Mailing Address
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Address Line | 1701 NORTH SANDHILLS BLVD.
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City | ABERDEEN
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State | NC
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Zip | 28315
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Country | US
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Telephone | 910-944-7889
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Fax | 910-944-0899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY PAUL DACKOR
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Credential | DC
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Telephone | 910-944-7889
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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 | 695
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License Number State | NC
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