Provider Demographics
NPI:1184209223
Name:ADVANTAGE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:ADVANTAGE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:SURBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-627-5435
Mailing Address - Street 1:JARED SURBAUGH
Mailing Address - Street 2:2105 AMALFI PL.
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502
Mailing Address - Country:US
Mailing Address - Phone:304-627-5435
Mailing Address - Fax:910-399-7651
Practice Address - Street 1:1460 KELLY RD STE 102
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-9515
Practice Address - Country:US
Practice Address - Phone:304-627-5435
Practice Address - Fax:910-399-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty