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General NPI Number Information
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NPI Number | 1427154566
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Entity Type | Organization
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Legal Business Name | SOUTHERN PINES CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 361 N BENNETT ST
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4812
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Country | US
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Telephone | 910-692-5207
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Fax | 910-692-4487
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Provider Business Mailing Address
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Address Line | 361 N BENNETT ST
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4812
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Country | US
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Telephone | 910-692-5207
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Fax | 910-692-4487
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. CELIA COOK WAHL
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Credential | OFFICE MANAGER
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Telephone | 910-692-5207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1784
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License Number State | NC
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