MEDICARE: TODD HENRY FARISHIAN

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
1	111N00000X	Chiropractor	4224	NC

General Provider Information

NPI Number	:	1083018964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TODD HENRY FARISHIAN

Provider Business Mailing Address
First Line	:	2108 WERRINGTON DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3330
Country	:	US
Telephone Number	:	919-552-0751
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 WERRINGTON DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3330
Country	:	US
Telephone Number	:	919-552-0751
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TODD H FARISHIAN
Credential	:	DC
Telephone Number	:	919-552-0751

Provider Enumeration Date	:	10/21/2014
Last Update Date	:	10/21/2014

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