Provider Demographics
NPI:1083718233
Name:AVERICK, ELIZABETH HILL (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:HILL
Last Name:AVERICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6853 FAIRVIEW RD STE 100C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3662
Mailing Address - Country:US
Mailing Address - Phone:704-362-5400
Mailing Address - Fax:
Practice Address - Street 1:6853 FAIRVIEW RD STE 100C
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3662
Practice Address - Country:US
Practice Address - Phone:704-362-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1812111N00000X
SC2553111N00000X
FLCH5078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0853BOtherBLUE CROSS BLUE SHIELD
NC0853BOtherBLUE CROSS BLUE SHIELD
T48225Medicare UPIN