Organization
CHERRY POINT CHIROPRACTIC & REHABILITATION CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL KELSO DAVIS DC ATC (PRESIDENT CEO)
(252) 444-3377
Entity
Organization
Contact information
Practice address
318 E MAIN ST, HAVELOCK, NC 28532-2214
(252) 444-3377
(252) 444-3529
Mailing address
318 E MAIN ST, HAVELOCK, NC 28532-2214
(252) 444-3377
(252) 444-3529
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2801
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0844V
BLUE CROSS BLUE SHIELD
NC
01
—
7167352
AETNA
—
05
—
890844V
—
NC
Enumeration date
05/10/2006
Last updated
05/02/2016
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