MEDICARE: AMMONS CHIROPRACTIC PC

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	1154	NC

General Provider Information

NPI Number	:	1538265384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMMONS CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	1401 GREENWAY CT
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-6954
Country	:	US
Telephone Number	:	919-774-6111
Fax Number	:	919-774-9587

Provider Business Practice Location Address
First Line	:	1401 GREENWAY CT
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-6954
Country	:	US
Telephone Number	:	919-774-6111
Fax Number	:	919-774-9587

Authorized Official
Title or Position	:	CEO
Name	:	DR. DARYL LYNN AMMONS
Credential	:	D.C.
Telephone Number	:	919-774-6111

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/24/2009

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