Provider Demographics
NPI:1609502665
Name:XIONG, POLOYEN (DC)
Entity Type:Individual
Prefix:DR
First Name:POLOYEN
Middle Name:
Last Name:XIONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 GEORGE W LILES PKWY NW STE 150
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-2410
Mailing Address - Country:US
Mailing Address - Phone:704-802-1543
Mailing Address - Fax:
Practice Address - Street 1:350 GEORGE W LILES PKWY NW STE 150
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-2410
Practice Address - Country:US
Practice Address - Phone:704-802-1543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor