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General NPI Number Information
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NPI Number | 1427754514
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Entity Type | Organization
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Legal Business Name | FUEL CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 5021 SOUTHPORT CROSSING WAY STE 300
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City | SOUTHPORT
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State | NC
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Zip | 28461-2205
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Country | US
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Telephone | 910-393-7596
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Fax |
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Provider Business Mailing Address
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Address Line | 728 VILLAGE RD
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City | SHALLOTTE
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State | NC
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Zip | 28470-3412
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Country | US
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Telephone | 910-393-7596
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN SALVATORE LANK
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Credential | DC
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Telephone | 910-363-8140
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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 |
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License Number State |
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