MEDICARE: RUTHERFORD SPINE & INJURY CENTER, 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	111NI0013X	Independent Medical Examiner Chiropractor	2677	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669786497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUTHERFORD SPINE & INJURY CENTER, PC

Provider Business Mailing Address
First Line	:	222 CHARLOTTE RD
Second Line	:
City	:	RUTHERFORDTON
State	:	NC
Zip	:	28139-2914
Country	:	US
Telephone Number	:	828-286-3472
Fax Number	:	828-286-3478

Provider Business Practice Location Address
First Line	:	222 CHARLOTTE RD
Second Line	:
City	:	RUTHERFORDTON
State	:	NC
Zip	:	28139-2914
Country	:	US
Telephone Number	:	828-286-3472
Fax Number	:	828-286-3478

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHARLES SAYRE
Credential	:	D.C.
Telephone Number	:	828-286-3472

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	08/04/2010

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