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MYERS PARK CHIROPRACTIC PA NPI 1730394529


NPI Information

NPI: 1730394529
Provider Name: MYERS PARK CHIROPRACTIC PA

Doing Business As: CHARLOTTE WELLNESS CENTER

Classification: Chiropractor - 111N00000X
Entity Type: Organization

CLIA Number: 34D2131179

Address:
1000 QUEENS RD
SUITE 2
CHARLOTTE, NC
ZIP 28207
Phone: (704) 343-0208
Get Directions

MYERS PARK CHIROPRACTIC PA is a chiropractor in Charlotte, NC. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. MYERS PARK CHIROPRACTIC PA NPI is 1730394529. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Charlotte Wellness Center.

The provider's business location address is:

1000 QUEENS RD
SUITE 2
CHARLOTTE, NC
ZIP 28207-860
Phone: (704) 343-0208
Fax: (704) 343-0275

The provider's authorized official is Brian William Gotro .
The authorized official title is Owner and has the following contact phone number (704) 343-0208.

The CLIA number assigned to this NPI record is 34D2131179 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/14/2007 and was last updated on 3/18/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor2603NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1U72491MEDICARE UPINNORTH CAROLINA
20842YOTHERNORTH CAROLINABCBS PROVIDER NUMBER
31730394529OTHERNORTH CAROLINAGROUP NPI
41396757027OTHERNORTH CAROLINAINDIVIDUAL NPI NUMBER
5890842YMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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