Provider Demographics
NPI:1013781020
Name:FAYETTEVILLE CHIROPRACTIC SOLUTIONS PA
Entity type:Organization
Organization Name:FAYETTEVILLE CHIROPRACTIC SOLUTIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-484-5999
Mailing Address - Street 1:205 OWEN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3409
Mailing Address - Country:US
Mailing Address - Phone:910-484-5999
Mailing Address - Fax:910-484-2523
Practice Address - Street 1:205 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3409
Practice Address - Country:US
Practice Address - Phone:910-484-5999
Practice Address - Fax:910-484-2523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty