Provider Demographics
NPI:1801448758
Name:HIGH COUNTRY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:HIGH COUNTRY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:NEILL
Authorized Official - Last Name:BULLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-773-5182
Mailing Address - Street 1:638 GEORGE WILSON RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8613
Mailing Address - Country:US
Mailing Address - Phone:828-773-5182
Mailing Address - Fax:
Practice Address - Street 1:1228 LIBERTY CHURCH RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-4305
Practice Address - Country:US
Practice Address - Phone:423-727-7713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center