Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 3191 | NC |
NPI | 1174549273 |
---|---|
Provider Name | Dr. Joseph Vincent Picone |
First Address | Columbus, NC 28722-4479 |
Second Address | Columbus, NC 28722-4479 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 17/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T55029 | (02) | NC |