Provider Demographics
NPI:1003013186
Name:CENTER FOR CHIROPRACTIC & WELLNESS, PLLC
Entity Type:Organization
Organization Name:CENTER FOR CHIROPRACTIC & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-845-3280
Mailing Address - Street 1:8300 HEALTH PARK
Mailing Address - Street 2:SUITE 133
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4730
Mailing Address - Country:US
Mailing Address - Phone:919-845-3280
Mailing Address - Fax:919-845-3276
Practice Address - Street 1:8300 HEALTH PARK
Practice Address - Street 2:SUITE 133
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4730
Practice Address - Country:US
Practice Address - Phone:919-845-3280
Practice Address - Fax:919-845-3276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3447111N00000X
NC3373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty