MEDICARE: NELSON & NELSON VI, P.C.

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	2169	NC

General Provider Information

NPI Number	:	1871609750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NELSON & NELSON VI, P.C.

Provider Business Mailing Address
First Line	:	6021 RAEFORD RD
Second Line	:	SUITE 101
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3053
Country	:	US
Telephone Number	:	910-860-5559
Fax Number	:	910-860-1165

Provider Business Practice Location Address
First Line	:	6021 RAEFORD RD
Second Line	:	SUITE 101
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3053
Country	:	US
Telephone Number	:	910-860-5559
Fax Number	:	910-860-1165

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GARRY NELSON
Credential	:	D.C.
Telephone Number	:	910-964-2070

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/22/2020

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