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General NPI Number Information
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NPI Number | 1497634174
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Entity Type | Organization
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Legal Business Name | ELITE LASER PAIN & CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 470 MAGNOLIA SQUARE CT
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City | ABERDEEN
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State | NC
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Zip | 28315-2763
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Country | US
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Telephone | 410-900-3758
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Fax | 910-900-3768
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Provider Business Mailing Address
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Address Line | 470 MAGNOLIA SQUARE CT
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City | ABERDEEN
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State | NC
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Zip | 28315-2763
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Country | US
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Telephone | 410-900-3758
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Fax | 910-900-3768
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN S DIAL
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Credential | D.C.
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Telephone | 910-736-4999
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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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