Organization
LAUREL PARK CHIROPRACTIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER WAYNE FREED D.C. (OWNER)
(828) 696-9090
Entity
Organization
Contact information
Practice address
212 S GROVE ST, SUITE D, HENDERSONVILLE, NC 28792-4006
(828) 696-9090
Mailing address
212 S GROVE ST, SUITE D, HENDERSONVILLE, NC 28792-4006
(828) 696-9090
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2136
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139C
BCBSNC PROVIDER ID
NC
Enumeration date
09/13/2006
Last updated
11/27/2012
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