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Organization

IN HOME CHIROPRACTIC & PERSONAL TRAINING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAREN Z BETHEA II DC (OWNER)
(704) 295-1641
Entity
Organization

Contact information

Practice address
500 E MOREHEAD ST, SUITE 216, CHARLOTTE, NC 28202-2616
(704) 295-1641
(704) 295-1498
Mailing address
68 GLOBAL DR, SUITE 100, GREENVILLE, SC 29607-4628
(864) 644-2700
(864) 644-2709

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3802
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3802
DC LICENSE
NC
Enumeration date
02/08/2010
Last updated
10/28/2010
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