Provider Demographics
NPI:1710049515
Name:HOLLY SPRINGS CHIROPRACTIC PA
Entity Type:Organization
Organization Name:HOLLY SPRINGS CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-552-8011
Mailing Address - Street 1:125 HOLLY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9423
Mailing Address - Country:US
Mailing Address - Phone:919-552-8011
Mailing Address - Fax:919-557-1285
Practice Address - Street 1:125 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9423
Practice Address - Country:US
Practice Address - Phone:919-552-8011
Practice Address - Fax:919-557-1285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3160302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085K2Medicaid
NC89085K2Medicaid