Provider Demographics
NPI:1265663033
Name:SELLE, ERIC J (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:SELLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 NW MAYNARD RD STE 112
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3402
Mailing Address - Country:US
Mailing Address - Phone:919-617-1164
Mailing Address - Fax:919-617-1164
Practice Address - Street 1:1750 NW MAYNARD RD STE 112
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3402
Practice Address - Country:US
Practice Address - Phone:919-617-1164
Practice Address - Fax:919-617-1164
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor