Provider Demographics
NPI:1578533378
Name:JONATHAN N COLTER
Entity Type:Organization
Organization Name:JONATHAN N COLTER
Other - Org Name:HUNTERSVILLE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:COLTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-875-9800
Mailing Address - Street 1:PO BOX 2157
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28070-2157
Mailing Address - Country:US
Mailing Address - Phone:704-875-9800
Mailing Address - Fax:704-875-0298
Practice Address - Street 1:102G STATESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-875-9800
Practice Address - Fax:704-875-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890267PMedicaid
NC890267PMedicaid