Provider Demographics
NPI:1093083248
Name:LOMMEL CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:LOMMEL CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-663-3137
Mailing Address - Street 1:517 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-3122
Mailing Address - Country:US
Mailing Address - Phone:919-663-3137
Mailing Address - Fax:919-663-3137
Practice Address - Street 1:517 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3122
Practice Address - Country:US
Practice Address - Phone:919-663-3137
Practice Address - Fax:919-663-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1731261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2446730Medicare PIN
NCT40902Medicare UPIN