Provider Demographics
NPI:1164723607
Name:MCPHATTER FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:MCPHATTER FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHATTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-946-6518
Mailing Address - Street 1:327 CODDLE MARKET DRIVE
Mailing Address - Street 2:STE.120
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027
Mailing Address - Country:US
Mailing Address - Phone:614-946-6518
Mailing Address - Fax:
Practice Address - Street 1:327 CODDLE MARKET DRIVE
Practice Address - Street 2:STE.120
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027
Practice Address - Country:US
Practice Address - Phone:614-946-6518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty