Sam Brake, DC
Individual provider Active NPI Chiropractor · Cornelius, NC
NPI 1154513315 · NPPES record last updated Aug 13, 2007
Key facts
- NPI
- 1154513315
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3320 (NC)
- Practice address
- 19315 W Catawba Ave
Suite 100
Cornelius, NC 28031-8650 - Phone
- (704) 896-1811
- Fax
- (704) 896-1812
- NPI assigned
- Aug 13, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Norman Pain Relief & Wellness | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3320 | NC | Yes |
Addresses
Primary practice location
19315 W Catawba Ave
Suite 100
Cornelius, NC 28031-8650
Mailing address
1570 Abercorn St NW
Concord, NC 28027-3545
Phone (704) 886-5156
Other providers in Cornelius, NC
- Melissa D Bowen
- Leslie Bowllan
- Kristopher Scott Boyd
- Kylie Boyer
- Andrew Curtis Brackins
- Tracey Renee Brake
- Bridge Plan, PLLC
- Bright Waves Counseling, PLLC
- Brightside ABA NC LLC
- Kristina Briscoe
All providers in Cornelius, NC · Chiropractor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.