Provider Demographics
NPI:1669866216
Name:HATTERSLEY CHIROPRACTIC CLINIC, PC
Entity Type:Organization
Organization Name:HATTERSLEY CHIROPRACTIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HATTERSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-564-2612
Mailing Address - Street 1:9024 OTTER CREEK DR APT H
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1439
Mailing Address - Country:US
Mailing Address - Phone:704-564-2612
Mailing Address - Fax:
Practice Address - Street 1:10430 PARK RD
Practice Address - Street 2:SUITE 100B
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8540
Practice Address - Country:US
Practice Address - Phone:704-614-6184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-21
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty