1972687333 NPI number — SILVER CHIROPRACTIC CORP

Table of content: (NPI 1972687333)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972687333 NPI number — SILVER CHIROPRACTIC CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SILVER CHIROPRACTIC CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SOUTHEAST CHIROPRACTIC: THE MOTION CENTERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972687333
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 N HIGHWAY 16
Provider Second Line Business Mailing Address:
#102
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28037-3000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-649-6697
Provider Business Mailing Address Fax Number:
704-892-9793

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 N HIGHWAY 16
Provider Second Line Business Practice Location Address:
#102
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28037-3000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-649-6697
Provider Business Practice Location Address Fax Number:
704-892-9793
Provider Enumeration Date:
10/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SILVER
Authorized Official First Name:
JODIE
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
CHIROPRACTOR OWNER
Authorized Official Telephone Number:
704-649-6697

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2680 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 2544 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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