Provider Demographics
NPI:1255669644
Name:HOCTOR CHIROPRACTIC AND FAMILY WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:HOCTOR CHIROPRACTIC AND FAMILY WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-896-1983
Mailing Address - Street 1:20721 TORRENCE CHAPEL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6398
Mailing Address - Country:US
Mailing Address - Phone:704-896-1983
Mailing Address - Fax:704-896-5756
Practice Address - Street 1:20721 TORRENCE CHAPEL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6398
Practice Address - Country:US
Practice Address - Phone:704-896-1983
Practice Address - Fax:704-896-5756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4007111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty