| |
1171 N Bragg Blvd, Spring Lake, NC 28390-3116 | |
(910) 436-5000 | |
(910) 436-7705 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 1171 N Bragg Blvd, Spring Lake, 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 |
---|---|---|---|
1013914977 | NPI | - | NPPES |
89013FC | Medicaid | NC | |
89013FC | Other | NC | BCBS GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 1830 (North Carolina) | Primary |
Provider Name | Tina Marie Driscoll |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1083611040 PECOS PAC ID: 6002089380 Enrollment ID: I20111128000785 |
Mailing Address | Practice Location Address |
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508 Glenola St, Fayetteville, NC 28311-3206 Ph: (910) 822-3221 | 1171 N Bragg Blvd, Spring Lake, NC 28390-3116 Ph: (910) 436-5000 |
Dr. Tina Marie Driscoll, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1171 N Bragg Blvd, Spring Lake, NC 28390 Phone: 910-436-5000 Fax: 910-436-7705 |