Provider Demographics
NPI:1336545243
Name:NATIONS FAMILY CHIROPRACTIC PA
Entity type:Organization
Organization Name:NATIONS FAMILY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:LOVELESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-844-6368
Mailing Address - Street 1:1730 MATTHEWS TOWNSHIP PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4927
Mailing Address - Country:US
Mailing Address - Phone:704-844-6368
Mailing Address - Fax:704-844-6369
Practice Address - Street 1:1730 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4927
Practice Address - Country:US
Practice Address - Phone:704-844-6368
Practice Address - Fax:704-844-6369
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONS FAMILY CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-05
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCL997E286Medicare UPIN