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NPI Code Detail

MEDICARE: GOLDSBORO SPINE CENTER, PA

MEDICARE: GOLDSBORO SPINE CENTER, PA
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
1111N00000XChiropractor

General Provider Information

NPI Number : 1538462106
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOLDSBORO SPINE CENTER, PA
Provider Business Mailing Address
First Line : 605 N SPENCE AVE
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-4263
Country : US
Telephone Number : 919-751-0555
Fax Number : 919-751-3001
Provider Business Practice Location Address
First Line : 605 N SPENCE AVE
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-4263
Country : US
Telephone Number : 919-751-0555
Fax Number : 919-751-3001
Authorized Official
Title or Position : INCORPORATOR/DIRECTOR
Name : DR. TORRI FAIR GAMBACORTA
Credential : DC
Telephone Number : 919-751-0555
Provider Enumeration Date : 12/21/2010
Last Update Date : 12/21/2010

Similar Medicare Providers

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1336926849 — ALFER JOHN ADLAWAN PTA
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Directions to “GOLDSBORO SPINE CENTER, PA ” Practice Location

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