Organization
LAKE NORMAN CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD FULTON ABERNATHY D.C., C.C.S.P. (PRESIDENT)
(704) 664-3455
Entity
Organization
Contact information
Practice address
612 N MAIN ST, MOORESVILLE, NC 28115-2312
(704) 664-3455
(704) 664-2827
Mailing address
612 N MAIN ST, MOORESVILLE, NC 28115-2312
(704) 664-3455
(704) 664-2827
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
111NS0005X
Sports Physician Chiropractor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0194L
CNC (BCBS)
NC
01
—
085A6
BCBS INDIVIDUAL
NC
01
—
208640
QUAILCHOICE
NC
01
—
350053151
RAILROAD MEDICARE
NC
01
—
42162996
WAUSAU
NC
01
—
43954
PARTNERS INDIVIDUAL
NC
01
—
4881
PARTNERS GROUP
NC
01
—
53164
AWHN
NC
01
—
5909823002
CIGNA PAL
NC
01
—
617420
ACN
NC
01
—
7741266
AETNA
NC
05
—
89085A6
—
NC
Enumeration date
06/20/2006
Last updated
10/06/2011
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