Provider Demographics
NPI:1699845370
Name:FARRELL CLINIC OF CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:FARRELL CLINIC OF CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-254-7171
Mailing Address - Street 1:152 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1853
Mailing Address - Country:US
Mailing Address - Phone:828-254-7171
Mailing Address - Fax:828-254-7229
Practice Address - Street 1:152 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1853
Practice Address - Country:US
Practice Address - Phone:828-254-7171
Practice Address - Fax:828-254-7229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08407OtherBCBS
NC9008407Medicaid
NC9008407Medicaid