Provider Demographics
NPI:1457467334
Name:NELSON & NELSON IV, P.C.
Entity Type:Organization
Organization Name:NELSON & NELSON IV, P.C.
Other - Org Name:NELSON & NELSON CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-964-2070
Mailing Address - Street 1:409 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-5623
Mailing Address - Country:US
Mailing Address - Phone:910-608-2224
Mailing Address - Fax:910-608-2055
Practice Address - Street 1:409 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5623
Practice Address - Country:US
Practice Address - Phone:910-608-2224
Practice Address - Fax:910-608-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty