| Om Spa Chiropractic & Wellness,p.c. | |
|
523 Fenton Pl, Charlotte, NC 28207-1919 | |
| (704) 302-1524 | |
| (980) 875-9531 |
| Full Name | Om Spa Chiropractic & Wellness,p.c. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 523 Fenton Pl, Charlotte, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699943548 | NPI | - | NPPES |
| 89085M2 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Bryan S Edmiston |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1427142066 PECOS PAC ID: 3870579915 Enrollment ID: I20040628001622 |
| Provider Name | Colin Renaud |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134578735 PECOS PAC ID: 1759618598 Enrollment ID: I20190816000048 |
| Mailing Address | Practice Location Address |
|---|---|
| Om Spa Chiropractic & Wellness,p.c. 523 Fenton Pl, Charlotte, NC 28207-1919 Ph: (704) 302-1524 | Om Spa Chiropractic & Wellness,p.c. 523 Fenton Pl, Charlotte, NC 28207-1919 Ph: (704) 302-1524 |
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