Provider Demographics
NPI:1235483959
Name:DURAN-NEGRON, PAOLA (DC)
Entity Type:Individual
Prefix:DR
First Name:PAOLA
Middle Name:
Last Name:DURAN-NEGRON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:PAOLA
Other - Middle Name:
Other - Last Name:DURAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:4911 BRIDGER RD
Mailing Address - Street 2:PO BOX 1945
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-4474
Mailing Address - Country:US
Mailing Address - Phone:910-755-5483
Mailing Address - Fax:910-755-5484
Practice Address - Street 1:4911 BRIDGER RD
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4474
Practice Address - Country:US
Practice Address - Phone:910-755-5483
Practice Address - Fax:910-755-5484
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor