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General NPI Number Information
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NPI Number | 1720033632
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Entity Type | Organization
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Legal Business Name | INDIAN TRAIL CHIROPRACTIC & REHABILITATION, P.A.
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 100 PARK RD E
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-7622
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Country | US
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Telephone | 704-821-3222
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Fax | 704-821-3290
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Provider Business Mailing Address
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Address Line | PO BOX 812
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-0812
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Country | US
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Telephone | 704-821-3222
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Fax | 704-821-3290
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW MICHAEL EVEC
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Credential | D.C.
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Telephone | 704-821-3222
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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 | 2732
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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