Organization
BANNON CLINIC OF CHIROPRACTIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY S. BANNON D.C. (DOCTOR)
(704) 864-7774
Entity
Organization
Contact information
Practice address
1002 S NEW HOPE RD, GASTONIA, NC 28054-3801
(704) 864-7774
(704) 810-8998
Mailing address
1002 S NEW HOPE RD, GASTONIA, NC 28054-3801
(704) 864-7774
(704) 810-8998
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2804
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890842V
—
NC
Enumeration date
10/13/2006
Last updated
09/08/2010
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