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NPI Code Detail

MEDICARE: MCMASTERS CHIROPRACTIC CENTER PLLC

MEDICARE: MCMASTERS CHIROPRACTIC CENTER PLLC
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
1111N00000XChiropractor4031NC

General Provider Information

NPI Number : 1790009504
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCMASTERS CHIROPRACTIC CENTER PLLC
Provider Business Mailing Address
First Line : 1037 HOMELAND AVE
Second Line : UNIT B
City : GREENSBORO
State : NC
Zip : 27405-7003
Country : US
Telephone Number : 336-617-4783
Fax Number :
Provider Business Practice Location Address
First Line : 1037 HOMELAND AVE
Second Line : UNIT B
City : GREENSBORO
State : NC
Zip : 27405-7003
Country : US
Telephone Number : 336-617-4783
Fax Number :
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. KIM LAVETTE MCMASTERS
Credential : DC
Telephone Number : 336-617-4783
Provider Enumeration Date : 03/23/2010
Last Update Date : 03/23/2010

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Directions to “MCMASTERS CHIROPRACTIC CENTER PLLC ” Practice Location

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