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General NPI Number Information
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NPI Number | 1295950954
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Entity Type | Organization
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Legal Business Name | MARTIN CHIROPRACTIC AND ACUPUNCTURE, PC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8404 SIX FORKS RD STE. 203
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City | RALEIGH
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State | NC
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Zip | 27615-3072
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Country | US
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Telephone | 859-351-2635
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Fax |
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Provider Business Mailing Address
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Address Line | 8404 SIX FORKS RD STE. 203
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City | RALEIGH
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State | NC
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Zip | 27615-3072
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Country | US
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Telephone | 859-351-2635
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAWN PATRICK MARTIN
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Credential | D.C.
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Telephone | 859-351-2635
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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 | 3656
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License Number State | NC
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