Organization
MT. OLIVE CHIROPRACTIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASSOUD MOTAMED D.C., F.A.S.A. (PRESIDENT, D.C.)
(919) 658-0003
Entity
Organization
Contact information
Practice address
515 W MAIN ST, MOUNT OLIVE, NC 28365-1903
(919) 658-0003
(919) 658-0310
Mailing address
515 W MAIN ST, MOUNT OLIVE, NC 28365-1903
(919) 658-0003
(919) 658-0310
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2404
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0820M
BLUE CROSS
NC
05
—
890820M
—
NC
Enumeration date
09/15/2006
Last updated
08/22/2020
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