1437223393 NPI number — T&W CHIROPRACTIC SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437223393 NPI number — T&W CHIROPRACTIC SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
T&W CHIROPRACTIC SERVICES, 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:
6
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:
1437223393
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6958 NEXUS CT
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28304-2648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-864-9400
Provider Business Mailing Address Fax Number:
910-860-2417

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6958 NEXUS CT
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304-2648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-864-9400
Provider Business Practice Location Address Fax Number:
910-860-2417
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TINSLEY
Authorized Official First Name:
JOHNATHAN
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
910-864-9400

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2684 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 890844J , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2454074 . This is a "MEDICARE PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0844J . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7368199 . This is a "AETNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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