1942778287 NPI number — ESSENTIAL FAMILY CHIROPRACTIC INC

Table of content: MS. COURTNEY PASE ERICKSON (NPI 1154683548)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942778287 NPI number — ESSENTIAL FAMILY CHIROPRACTIC INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESSENTIAL FAMILY CHIROPRACTIC INC
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:
Provider Other Organization Name Type Code:
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:
1942778287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
733 3RD AVE W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSONVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28739-4824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-280-7558
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
346 MERRIMON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-1222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-489-1572
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ARNOLD
Authorized Official First Name:
NELLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
828-489-1572

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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