Provider Demographics
NPI:1154970481
Name:100 PERCENT CHIROPRACTIC PADILLA, LLC
Entity type:Organization
Organization Name:100 PERCENT CHIROPRACTIC PADILLA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-507-0938
Mailing Address - Street 1:19722 ONE NORMAN BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5911
Mailing Address - Country:US
Mailing Address - Phone:980-689-2499
Mailing Address - Fax:
Practice Address - Street 1:19722 ONE NORMAN DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031
Practice Address - Country:US
Practice Address - Phone:704-507-0938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty