Provider Demographics
NPI:1003217209
Name:LUNDY HEALTHCARE PLLC
Entity Type:Organization
Organization Name:LUNDY HEALTHCARE PLLC
Other - Org Name:CAROLINA BEACH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-431-7970
Mailing Address - Street 1:2481 BELSHAW DR
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-6508
Mailing Address - Country:US
Mailing Address - Phone:910-431-7970
Mailing Address - Fax:
Practice Address - Street 1:1140 N LAKE PARK BLVD
Practice Address - Street 2:SUITE I
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428-4100
Practice Address - Country:US
Practice Address - Phone:910-431-7970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty