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Organization

KDW CHIROCARE INC

Active
Parent organization
REGIONAL CHIROPRACTIC CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
REGIONAL CHIROPRACTIC CENTER
Authorized official
DR. KRISTINE MARIE DEBOER D.C. (CHIROPRACTIC PHYSICIAN)
(980) 297-1414
Entity
Organization

Contact information

Practice address
736 BRAWLEY SCHOOL RD, SUITE E, MOORESVILLE, NC 28117-9282
(704) 664-1031
(704) 664-1035
Mailing address
2275 LAURENS DR, CONCORD, NC 28027-7637
(980) 297-1414
(704) 660-6932

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3509
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1750429189
GROUP NPI
NC
01
2459637A
GROUP MEDICARE
NC
01
2459637B
MEDICARE
NC
Enumeration date
02/01/2007
Last updated
12/20/2012
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