Provider Demographics
NPI:1336368711
Name:WHITE SULPHUR SPRINGS CHIROPRACTIC HEALTH CENTER
Entity type:Organization
Organization Name:WHITE SULPHUR SPRINGS CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-786-6565
Mailing Address - Street 1:2994 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-8222
Mailing Address - Country:US
Mailing Address - Phone:336-786-6565
Mailing Address - Fax:336-786-5110
Practice Address - Street 1:2994 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-8222
Practice Address - Country:US
Practice Address - Phone:336-786-6565
Practice Address - Fax:336-786-5110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5950023Medicaid
NC8908506Medicaid
NC08921OtherBCBSNC GROUP
NC5950023Medicaid
NC8908506Medicaid