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General NPI Number Information
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NPI Number | 1710002159
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTH AND CHIROPRACTIC CENTER, PLLC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 191A W PLAZA DR
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City | MOORESVILLE
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State | NC
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Zip | 28117
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Country | US
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Telephone | 704-664-4000
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Fax | 704-660-5251
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Provider Business Mailing Address
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Address Line | 191A W PLAZA DR
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City | MOORESVILLE
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State | NC
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Zip | 28117-6806
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Country | US
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Telephone | 704-664-4000
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Fax | 704-660-5251
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Authorized Official
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Title or Position | OWNER PROVIDER
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Name | MR. RYAN SCOTT ROBINSON
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Credential | DC
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Telephone | 704-664-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17659
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2900
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License Number State | NC
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