Provider Demographics
NPI:1295025385
Name:DURHAM CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:DURHAM CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARNEY
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:386-546-3006
Mailing Address - Street 1:147 W BANNERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-8207
Mailing Address - Country:US
Mailing Address - Phone:386-546-3006
Mailing Address - Fax:
Practice Address - Street 1:306 REID ST
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3732
Practice Address - Country:US
Practice Address - Phone:386-546-3006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty