Provider Demographics
NPI:1629169339
Name:BURRIS, RAY LESTER (DC)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:LESTER
Last Name:BURRIS
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 1:108 S POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3320
Mailing Address - Country:US
Mailing Address - Phone:704-735-7272
Mailing Address - Fax:704-735-9598
Practice Address - Street 1:108 S POPLAR ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3320
Practice Address - Country:US
Practice Address - Phone:704-735-7272
Practice Address - Fax:704-735-9598
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890828AMedicaid
NC2447362Medicare ID - Type UnspecifiedMEDICARE
NCU30751Medicare UPIN