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NPI Code Detail

MEDICARE: DR. RANDALL LEE PLANCK II D.C.

MEDICARE: DR. RANDALL LEE PLANCK II D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor4169NC

General Provider Information

NPI Number : 1033416201
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL LEE PLANCK II D.C.
Provider Business Mailing Address
First Line : 5344 CENTRAL AVE
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-2704
Country : US
Telephone Number : 704-940-4000
Fax Number : 704-940-4001
Provider Business Practice Location Address
First Line : 5344 CENTRAL AVE
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-2704
Country : US
Telephone Number : 704-940-4000
Fax Number : 704-940-4001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 10/19/2012

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