=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891033536
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WNC CHIROPRACTIC AND WELLNESS CENTER, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2013
-----------------------------------------------------
Last Update Date | 01/30/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 192 E CHESTNUT ST SUITE D
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-2350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-255-0007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 171
-----------------------------------------------------
City | GERTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28735-0171
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KATHRYN MURRAY
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 828-702-8709
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 4051
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------