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General NPI Number Information
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NPI Number | 1528592037
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Entity Type | Organization
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Legal Business Name | MODERN HEALTH INSTITUTE PC
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 1140 HOLLY SPRINGS RD #210
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-9634
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Country | US
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Telephone | 919-404-9423
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 HOLLY SPRINGS RD #210
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-9634
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Country | US
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Telephone | 919-404-9423
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | ERIC GINTER
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Credential | D.C.
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Telephone | 919-404-9423
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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 | 2555
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License Number State | NC
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