Provider Demographics
NPI:1770674459
Name:HORN CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:HORN CHIROPRACTIC CENTER INC
Other - Org Name:HORN CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-537-2425
Mailing Address - Street 1:PO BOX 2052
Mailing Address - Street 2:
Mailing Address - City:ROANAKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-3165
Mailing Address - Country:US
Mailing Address - Phone:252-537-2425
Mailing Address - Fax:252-537-4809
Practice Address - Street 1:400 BECKER DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:ROANAKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-3165
Practice Address - Country:US
Practice Address - Phone:252-537-2425
Practice Address - Fax:252-537-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2213111N00000X
NC2212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02314OtherBCBS
CG4548OtherRAILROAD MEDICARE
NC6902314Medicaid
NC02314OtherBCBS