Organization
SOUTH MAIN CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L. BULLARD-KELLEY D.C. (OWNER)
(336) 885-5200
Entity
Organization
Contact information
Practice address
1920 S MAIN ST, HIGH POINT, NC 27260-4425
(336) 885-5200
(336) 885-5250
Mailing address
1920 S MAIN ST, HIGH POINT, NC 27260-4425
(336) 885-5200
(336) 885-5250
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2026
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0827K
BLUE CROSS/BLUE SHIELD
NC
05
—
890827K
—
NC
Enumeration date
01/29/2008
Last updated
01/29/2008
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