=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922066059
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL B . PRYOR
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2006
-----------------------------------------------------
Last Update Date | 06/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2907 S MAIN ST
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28147-7903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-633-9335
-----------------------------------------------------
Fax | 704-633-1743
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2907 S MAIN ST
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28147-7903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-633-9335
-----------------------------------------------------
Fax | 704-633-1743
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DIRECTOR
-----------------------------------------------------
Name | DR. MICHAEL B PRYOR
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 704-633-9335
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 3365
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2406
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------