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General NPI Number Information
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NPI Number | 1578533378
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Entity Type | Organization
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Legal Business Name | JONATHAN N COLTER
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 102G STATESVILLE ROAD
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-875-9800
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Fax | 704-875-0298
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Provider Business Mailing Address
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Address Line | PO BOX 2157
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City | HUNTERSVILLE
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State | NC
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Zip | 28070-2157
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Country | US
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Telephone | 704-875-9800
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Fax | 704-875-0298
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN NEAL COLTER
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Credential | D.C.
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Telephone | 704-875-9800
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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 | 2012
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License Number State | NC
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