Provider Demographics
NPI:1245423417
Name:JU CHIROPRACTIC WELLNESS CENTER, P.A.
Entity Type:Organization
Organization Name:JU CHIROPRACTIC WELLNESS CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGHYUN
Authorized Official - Middle Name:
Authorized Official - Last Name:JU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-405-2002
Mailing Address - Street 1:2223 E NC HIGHWAY 54
Mailing Address - Street 2:SUITE K
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5233
Mailing Address - Country:US
Mailing Address - Phone:919-405-2002
Mailing Address - Fax:919-405-2005
Practice Address - Street 1:2223 E NC HIGHWAY 54
Practice Address - Street 2:SUITE K
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5233
Practice Address - Country:US
Practice Address - Phone:919-405-2002
Practice Address - Fax:919-405-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0194LOtherCNC
NC232171Medicare PIN