Provider Demographics
NPI:1205124583
Name:NEXT GENERATION HEALTH PA
Entity type:Organization
Organization Name:NEXT GENERATION HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:KRISTINE
Authorized Official - Last Name:CLEMENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-844-6368
Mailing Address - Street 1:1730 MATTHEWS TOWNSHIP PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4927
Mailing Address - Country:US
Mailing Address - Phone:704-844-6368
Mailing Address - Fax:704-844-6369
Practice Address - Street 1:1730 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4927
Practice Address - Country:US
Practice Address - Phone:704-844-6368
Practice Address - Fax:704-844-6369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty