Provider Demographics
NPI:1336478049
Name:MCMASTERS, KIM LAVETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:LAVETTE
Last Name:MCMASTERS
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 1:505 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-4869
Mailing Address - Country:US
Mailing Address - Phone:336-253-5817
Mailing Address - Fax:
Practice Address - Street 1:1037 HOMELAND AVE
Practice Address - Street 2:UNIT B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7003
Practice Address - Country:US
Practice Address - Phone:336-617-4783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor