Provider Demographics
NPI:1417063397
Name:ATKINSON FAMILY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:ATKINSON FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-827-6560
Mailing Address - Street 1:7547 WATERSIDE LOOP RD
Mailing Address - Street 2:B
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-7678
Mailing Address - Country:US
Mailing Address - Phone:704-827-6560
Mailing Address - Fax:704-827-6717
Practice Address - Street 1:7547 WATERSIDE LOOP RD
Practice Address - Street 2:B
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-7678
Practice Address - Country:US
Practice Address - Phone:704-827-6560
Practice Address - Fax:704-827-6717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2349802Medicare ID - Type Unspecified