Provider Demographics
NPI:1609026723
Name:WADESBORO CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:WADESBORO CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-694-7246
Mailing Address - Street 1:207 MORVEN RD
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-2738
Mailing Address - Country:US
Mailing Address - Phone:704-694-7246
Mailing Address - Fax:704-694-6826
Practice Address - Street 1:207 MORVEN RD
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2738
Practice Address - Country:US
Practice Address - Phone:704-694-7246
Practice Address - Fax:704-694-6826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty