Provider Demographics
NPI:1902980295
Name:DENNIS L. HALL, DC PA CHURCH ST NORTH
Entity Type:Organization
Organization Name:DENNIS L. HALL, DC PA CHURCH ST NORTH
Other - Org Name:HALL CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:704-782-0111
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28026-0312
Mailing Address - Country:US
Mailing Address - Phone:704-782-0111
Mailing Address - Fax:704-788-1896
Practice Address - Street 1:217 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4763
Practice Address - Country:US
Practice Address - Phone:704-782-0111
Practice Address - Fax:704-788-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2453931Medicare ID - Type Unspecified