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General NPI Number Information
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NPI Number | 1295831246
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Entity Type | Organization
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Legal Business Name | CHEUVRONT CLINIC OF CHIROPRACTIC & SPORTS MEDICINE INC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 455 W JOHN ST
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City | MATTHEWS
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State | NC
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Zip | 28105-5354
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Country | US
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Telephone | 704-841-2200
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Fax | 704-841-2534
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Provider Business Mailing Address
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Address Line | 455 W JOHN ST
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City | MATTHEWS
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State | NC
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Zip | 28105-5354
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Country | US
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Telephone | 704-841-2200
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Fax | 704-841-2534
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. TIMOTHY SHAWN CHEUVRONT
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Credential | DC
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Telephone | 704-841-2200
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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 | 2128
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License Number State | NC
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