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General NPI Number Information
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NPI Number | 1386076693
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Entity Type | Organization
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Legal Business Name | CAROLINA CHIROPRACTIC CENTER P A
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 2007 W VANDALIA RD
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City | GREENSBORO
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State | NC
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Zip | 27407-7617
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Country | US
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Telephone | 336-855-6316
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Fax |
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Provider Business Mailing Address
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Address Line | 2007 W VANDALIA RD
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City | GREENSBORO
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State | NC
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Zip | 27407-7617
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Country | US
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Telephone | 336-855-6316
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARY W MCKEEL
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Credential | D.C.
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Telephone | 336-855-6316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 1107
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License Number State | NC
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