Provider Demographics
NPI:1518161652
Name:CARE ONE CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:CARE ONE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:FACCONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-565-4999
Mailing Address - Street 1:201 W ARROWOOD RD
Mailing Address - Street 2:SUITE EE
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-4054
Mailing Address - Country:US
Mailing Address - Phone:704-565-4999
Mailing Address - Fax:704-334-7059
Practice Address - Street 1:201 W ARROWOOD RD
Practice Address - Street 2:SUITE EE
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-4054
Practice Address - Country:US
Practice Address - Phone:704-565-4999
Practice Address - Fax:704-334-7059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1063615532Medicare ID - Type Unspecified