Organization Name: | NORTHLAKE CHIROPRACTIC PC |
NPI Number: | 1174793780 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LESLIE JEANNETTE MACKLIN (PRESIDENT/OWNER) |
Mailing Address: | 9325 Center Lake Dr Ste 150 Charlotte |
State: | NC US |
Postal Code: | 282160785 |
Phone Number: | 7044944250 |
Fax Number: | 7044944256 |
NPI Enumeration Date: | 03/11/2008 |
NPI Last Update Date: | 08/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 3690 |
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. |