Provider Demographics
NPI:1184485179
Name:MUNSON, COLE (DC)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:MUNSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19210 CHANDLERS LANDING DR APT 202
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4543
Mailing Address - Country:US
Mailing Address - Phone:716-720-1683
Mailing Address - Fax:
Practice Address - Street 1:20462 CHARTWELL CENTER DR STE D
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6596
Practice Address - Country:US
Practice Address - Phone:704-237-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5721111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor