Provider Demographics
NPI:1033559547
Name:SWISSCHIROPRACTIC CLINIQUE PA
Entity Type:Organization
Organization Name:SWISSCHIROPRACTIC CLINIQUE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PIERRE-YVES
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-484-1400
Mailing Address - Street 1:55 VILCOM CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1689
Mailing Address - Country:US
Mailing Address - Phone:919-484-1400
Mailing Address - Fax:
Practice Address - Street 1:55 VILCOM CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1689
Practice Address - Country:US
Practice Address - Phone:919-484-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty