Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1481 | NC |
NPI | 1003808833 |
---|---|
Provider Name | Scott W. Firczak |
First Address | Greenville, SC 29607-4628 |
Second Address | Charlotte, NC 28207-1216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 09/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7908143 | (05) | NC |
DA4928 | RAILROAD GROUP NUMBER (01) | NC |
P0060858 | RAILROAD PHYSICIAN NUMBER (01) | NC |