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General NPI Number Information
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NPI Number | 1336253426
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Entity Type | Organization
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Legal Business Name | NELSON BROTHERS CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3202 N MAIN ST SUITE 112
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City | HOPE MILLS
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State | NC
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Zip | 28348-1831
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Country | US
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Telephone | 910-426-9112
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Fax | 910-426-3802
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Provider Business Mailing Address
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Address Line | 3202 N MAIN ST SUITE 112
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City | HOPE MILLS
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State | NC
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Zip | 28348-1831
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Country | US
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Telephone | 910-426-9112
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Fax | 910-426-3802
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARRY NELSON
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Credential | D.C.
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Telephone | 910-964-2070
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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 | 2169
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License Number State | NC
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