Provider Demographics
NPI:1891396180
Name:UNION COUNTY ACCIDENT & INJURY CLIN
Entity Type:Organization
Organization Name:UNION COUNTY ACCIDENT & INJURY CLIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-283-5599
Mailing Address - Street 1:2204 W ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2762
Mailing Address - Country:US
Mailing Address - Phone:704-283-5599
Mailing Address - Fax:704-282-0317
Practice Address - Street 1:2204 W ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-2762
Practice Address - Country:US
Practice Address - Phone:704-283-5599
Practice Address - Fax:704-282-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty