=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801064902
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAJORS WELLNESS CENTER, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2008
-----------------------------------------------------
Last Update Date | 02/12/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 W KING ST STE. 2
-----------------------------------------------------
City | KINGS MOUNTAIN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28086-3414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-739-3373
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 110 W KING ST STE. 2
-----------------------------------------------------
City | KINGS MOUNTAIN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28086-3414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-739-3373
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. WILLIAM JOHN MAJORS III
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 704-739-3373
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2580
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------