Provider Demographics
NPI:1033288543
Name:DUMAYNE CHIROPRACTIC
Entity Type:Organization
Organization Name:DUMAYNE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-584-4008
Mailing Address - Street 1:404 HUFFMAN MILL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5296
Mailing Address - Country:US
Mailing Address - Phone:336-584-4008
Mailing Address - Fax:
Practice Address - Street 1:404 HUFFMAN MILL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5296
Practice Address - Country:US
Practice Address - Phone:336-584-4008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC111N00000X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0845FOtherBLUE CROSS BLUE SHIELD NC
NC890845FMedicaid
NC0845FOtherBLUE CROSS BLUE SHIELD NC