| Southpark Chiropractic Center Inc | |
|
6626 Fairview Rd, Charlotte, NC 28210 | |
| (704) 362-5400 | |
| Not Available |
| Full Name | Southpark Chiropractic Center Inc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 6626 Fairview Rd, 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 |
|---|---|---|---|
| 1386714681 | NPI | - | NPPES |
| 0853B | Other | NC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 1812 (North Carolina) | Primary |
| 111N00000X | Chiropractor | 2553 (South Carolina) | Secondary |
| 111N00000X | Chiropractor | CH5078 (Florida) | Secondary |
| Provider Name | Elizabeth H Averick |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083718233 PECOS PAC ID: 1759418114 Enrollment ID: I20100416000550 |
| Mailing Address | Practice Location Address |
|---|---|
| Southpark Chiropractic Center Inc 6626 Fairview Rd, Charlotte, NC 28210 Ph: (704) 362-5400 | Southpark Chiropractic Center Inc 6626 Fairview Rd, Charlotte, NC 28210 Ph: (704) 362-5400 |
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