Organization
PROACTIVE CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S GUERRIERO (PRESIDENT)
(704) 849-8171
Entity
Organization
Contact information
Practice address
300 E JOHN ST STE 130, MATTHEWS, NC 28105-4939
(704) 849-8171
Mailing address
300 E JOHN ST STE 130, MATTHEWS, NC 28105-4939
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085MH
BCBS
NC
01
—
623832
ACN
NC
01
—
7248444
AETNA
NC
01
—
78119
UPIN
NC
05
—
89085MH
—
NC
01
—
9363857
PHCS
NC
Enumeration date
08/30/2007
Last updated
08/30/2007
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