Provider Demographics
NPI:1164619920
Name:BEYOND WELLNESS CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:BEYOND WELLNESS CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-461-1836
Mailing Address - Street 1:5035 W WT HARRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1884
Mailing Address - Country:US
Mailing Address - Phone:704-461-1836
Mailing Address - Fax:704-248-0766
Practice Address - Street 1:5035 W WT HARRIS BLVD STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1884
Practice Address - Country:US
Practice Address - Phone:704-461-1836
Practice Address - Fax:704-248-0766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty