Provider Demographics
NPI:1457423857
Name:S TRAIN CHIROPRACTIC
Entity Type:Organization
Organization Name:S TRAIN CHIROPRACTIC
Other - Org Name:TRAIN CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-735-9668
Mailing Address - Street 1:1814 N ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-6303
Mailing Address - Country:US
Mailing Address - Phone:704-735-9668
Mailing Address - Fax:704-735-9775
Practice Address - Street 1:1814 N ASPEN ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-6303
Practice Address - Country:US
Practice Address - Phone:704-735-9668
Practice Address - Fax:704-735-9775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2449315BOtherMEDICARE PTAN
NC890822JMedicaid
NC890822JMedicaid
NC2449315BMedicare ID - Type Unspecified