Provider Demographics
NPI:1215029608
Name:KURTZ CHIROPRACTIC INC
Entity Type:Organization
Organization Name:KURTZ CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:OWENS
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-234-0000
Mailing Address - Street 1:3011 RALEIGH ROAD PARKWAY WEST
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896
Mailing Address - Country:US
Mailing Address - Phone:252-234-0000
Mailing Address - Fax:252-291-3232
Practice Address - Street 1:3011 RALEIGH ROAD PARKWAY WEST
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896
Practice Address - Country:US
Practice Address - Phone:252-234-0000
Practice Address - Fax:252-291-3232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02667OtherBCBS
NC8902667Medicaid
NC8902667Medicaid
NC02667OtherBCBS