Provider Demographics
NPI:1235536871
Name:CHIROCYNERGY, PA
Entity Type:Organization
Organization Name:CHIROCYNERGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-368-1723
Mailing Address - Street 1:1105 NEW POINTE BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-4130
Mailing Address - Country:US
Mailing Address - Phone:910-859-8359
Mailing Address - Fax:910-371-3144
Practice Address - Street 1:1105 NEW POINTE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-4130
Practice Address - Country:US
Practice Address - Phone:910-859-8359
Practice Address - Fax:910-371-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3742111N00000X
NC3779111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty