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General NPI Number Information
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NPI Number | 1497947642
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Entity Type | Organization
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Legal Business Name | RICHARD W. PROSSER, DC PA
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 845 CHURCH ST N SUITE 210
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City | CONCORD
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State | NC
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Zip | 28025-4300
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Country | US
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Telephone | 704-794-6239
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Fax | 704-794-6240
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Provider Business Mailing Address
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Address Line | 845 CHURCH ST N SUITE 210
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City | CONCORD
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State | NC
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Zip | 28025-4300
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Country | US
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Telephone | 704-794-6239
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Fax | 704-794-6240
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD WISE PROSSER
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Credential | DC
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Telephone | 704-794-6239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 1405
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License Number State | NC
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