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General NPI Number Information
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NPI Number | 1710300538
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Entity Type | Organization
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Legal Business Name | PASS FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 01/30/2014
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 2245 STANTONSBURG RD STE B
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City | GREENVILLE
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State | NC
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Zip | 27834-2868
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Country | US
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Telephone | 252-751-3866
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Fax | 252-757-1000
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Provider Business Mailing Address
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Address Line | P.O. BOX 30774
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City | GREENVILLE
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State | NC
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Zip | 27833
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Country | US
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Telephone | 910-734-4508
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON SMITH PASS
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Credential |
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Telephone | 252-751-3866
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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 | 4354
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License Number State | NC
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