Provider Demographics
NPI:1598965832
Name:DR JOHN RILEY DABBS
Entity Type:Organization
Organization Name:DR JOHN RILEY DABBS
Other - Org Name:EDEN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RILEY
Authorized Official - Last Name:DABBS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC,PC
Authorized Official - Phone:336-627-7398
Mailing Address - Street 1:405 BOONE RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-4967
Mailing Address - Country:US
Mailing Address - Phone:336-627-7398
Mailing Address - Fax:336-627-8421
Practice Address - Street 1:405 BOONE RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-4967
Practice Address - Country:US
Practice Address - Phone:336-627-7398
Practice Address - Fax:336-627-8421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR JOHN RILEY DABBS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2329111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty