Provider Demographics
NPI:1417919994
Name:WENTWORTH DOCTOR, NEVA R (DC)
Entity Type:Individual
Prefix:DR
First Name:NEVA
Middle Name:R
Last Name:WENTWORTH DOCTOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3315 SPRINGBANK LN
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3197
Mailing Address - Country:US
Mailing Address - Phone:704-341-3341
Mailing Address - Fax:888-341-4723
Practice Address - Street 1:3315 SPRINGBANK LN
Practice Address - Street 2:SUITE 304
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3197
Practice Address - Country:US
Practice Address - Phone:704-341-3341
Practice Address - Fax:888-341-4723
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS02076111N00000X
NC4095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor