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General NPI Number Information
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NPI Number | 1538172234
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Entity Type | Organization
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Legal Business Name | FENTON CHIROPRACTIC PA
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 101 7TH ST SW
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City | TAYLORSVILLE
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State | NC
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Zip | 28681-2409
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Country | US
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Telephone | 282-635-7400
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Fax | 828-635-7415
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | TAYLORSVILLE
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State | NC
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Zip | 28681-0429
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Country | US
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Telephone | 828-635-7400
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Fax | 282-635-7415
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. WAYNE JOHN FENTON
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Credential | D.C.
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Telephone | 828-635-7400
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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 | 2041
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License Number State | NC
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