Provider Demographics
NPI:1275674020
Name:CHMIELEWICZ, CARRIE LYNNEA (DC)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:LYNNEA
Last Name:CHMIELEWICZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 JOHNSTON RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-7855
Mailing Address - Country:US
Mailing Address - Phone:704-759-8006
Mailing Address - Fax:704-759-8216
Practice Address - Street 1:10801 JOHNSTON RD
Practice Address - Street 2:SUITE 112
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-7855
Practice Address - Country:US
Practice Address - Phone:704-759-8006
Practice Address - Fax:704-759-8216
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2454208AMedicare ID - Type Unspecified
NCU86845Medicare UPIN