Provider Demographics
NPI:1649725342
Name:CAROLINA FAMILY SPINE CENTER, PC
Entity type:Organization
Organization Name:CAROLINA FAMILY SPINE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:SIGMON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-601-5560
Mailing Address - Street 1:547 HIGHLAND ST
Mailing Address - Street 2:STE A
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-3117
Mailing Address - Country:US
Mailing Address - Phone:704-601-5560
Mailing Address - Fax:
Practice Address - Street 1:547 HIGHLAND ST
Practice Address - Street 2:STE A
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-3117
Practice Address - Country:US
Practice Address - Phone:704-601-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty