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General NPI Number Information
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NPI Number | 1558871459
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Entity Type | Individual
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Provider Name | JUSTIN DICK DC
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Gender | Male
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 10215 HICKORYWOOD HILL AVE STE C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3428
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Country | US
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Telephone | 980-368-0766
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Fax | 704-759-9020
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Provider Business Mailing Address
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Address Line | 10215 HICKORYWOOD HILL AVE STE C
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3428
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Country | US
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Telephone | 980-368-0766
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4741
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License Number State | NC
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