Provider Demographics
NPI:1477562940
Name:YEAGER CHIROPRACTIC AND WELLNESS CENTER, PC
Entity Type:Organization
Organization Name:YEAGER CHIROPRACTIC AND WELLNESS CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:YEAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-333-0550
Mailing Address - Street 1:100 N TRYON ST STE 165
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3264
Mailing Address - Country:US
Mailing Address - Phone:704-333-0550
Mailing Address - Fax:
Practice Address - Street 1:100 N TRYON ST STE 165
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3264
Practice Address - Country:US
Practice Address - Phone:704-333-0550
Practice Address - Fax:704-333-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty