Provider Demographics
NPI:1104983469
Name:GIANNARAS CHIROPRACTIC CENTRE, P.A.
Entity type:Organization
Organization Name:GIANNARAS CHIROPRACTIC CENTRE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:GIANNARAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-861-0224
Mailing Address - Street 1:811 S OAKLAND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0408
Mailing Address - Country:US
Mailing Address - Phone:704-861-0224
Mailing Address - Fax:704-861-0225
Practice Address - Street 1:811 S OAKLAND ST
Practice Address - Street 2:SUITE B
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0408
Practice Address - Country:US
Practice Address - Phone:704-861-0224
Practice Address - Fax:704-861-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2362261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-0847EMedicaid
NC245-3972Medicare ID - Type UnspecifiedGROUP NUMBER
NC0847EMedicare UPIN
NC89-0847EMedicaid