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General NPI Number Information
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NPI Number | 1427363563
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Entity Type | Organization
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Legal Business Name | BUCKINGHAM CHIROPRACTIC P.L.L.C.
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 13637 PROVIDENCE RD
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City | WEDDINGTON
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State | NC
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Zip | 28104-9373
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Country | US
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Telephone | 714-458-7665
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Fax |
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Provider Business Mailing Address
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Address Line | 16848 KETTLEWELL LN
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City | CHARLOTTE
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State | NC
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Zip | 28277-2724
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Country | US
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Telephone | 714-458-7665
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Fax |
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Authorized Official
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Title or Position | MEMBER/CHIROPRACTOR
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Name | DR. MICHAEL J BUCKINGHAM
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Credential | D.C.
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Telephone | 714-458-7665
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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 | 3471
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License Number State | NC
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