MEDICARE: DRILLING CHIROPRACTIC, INC

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	3749	NC

General Provider Information

NPI Number	:	1508161563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRILLING CHIROPRACTIC, INC

Provider Business Mailing Address
First Line	:	2305 E WT HARRIS BLVD STE 102
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-5133
Country	:	US
Telephone Number	:	704-921-0505
Fax Number	:	704-921-0508

Provider Business Practice Location Address
First Line	:	2305 E WT HARRIS BLVD STE 102
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-5133
Country	:	US
Telephone Number	:	704-921-0505
Fax Number	:	704-921-0508

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHAD R DRILLING
Credential	:	DC
Telephone Number	:	704-921-0505

Provider Enumeration Date	:	01/21/2011
Last Update Date	:	01/21/2011

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