Provider Demographics
NPI:1073781605
Name:BEYOND CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:BEYOND CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KANDYCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-543-5508
Mailing Address - Street 1:119 S TRADE ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5767
Mailing Address - Country:US
Mailing Address - Phone:704-543-5508
Mailing Address - Fax:
Practice Address - Street 1:119 S TRADE ST
Practice Address - Street 2:SUITE 108
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5767
Practice Address - Country:US
Practice Address - Phone:704-543-5508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-17
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty