Provider Demographics
NPI:1205366044
Name:STRUCTURAL CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:STRUCTURAL CHIROPRACTIC, PLLC
Other - Org Name:CASHIERS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BEACHUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-231-0747
Mailing Address - Street 1:PO BOX 1853
Mailing Address - Street 2:
Mailing Address - City:CASHIERS
Mailing Address - State:NC
Mailing Address - Zip Code:28717-1853
Mailing Address - Country:US
Mailing Address - Phone:828-743-9070
Mailing Address - Fax:828-743-6370
Practice Address - Street 1:130 US HWY 64 E
Practice Address - Street 2:
Practice Address - City:CASHIERS
Practice Address - State:NC
Practice Address - Zip Code:28717
Practice Address - Country:US
Practice Address - Phone:828-743-9070
Practice Address - Fax:828-743-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4699111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty