=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437257391
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PAI CLINIC OF CHIROPRACTIC & SPORTS MEDICINE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8821 UNIVERSITY EAST DR SUITE 100
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28213-4200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-599-0900
-----------------------------------------------------
Fax | 704-599-0998
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8821 UNIVERSITY EAST DR SUITE 100
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28213-4200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-599-0900
-----------------------------------------------------
Fax | 704-599-0998
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. NEIL KARNIRE PAI
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 704-599-0900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 2815
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------