| Organization Name: | ELLIS CHIROPRACTIC CENTER |
| NPI Number: | 1174760110 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAMMY G VERNON (OFFICE MANAGER) |
| Mailing Address: | 2109 New Garden Rd Suite B Greensboro |
| State: | NC US |
| Postal Code: | 274102540 |
| Phone Number: | 3362824123 |
| Fax Number: | 3365453369 |
| NPI Enumeration Date: | 01/13/2009 |
| NPI Last Update Date: | 01/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 3884 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |