Provider Demographics
NPI:1346315603
Name:FUQUAY CHIROPRACTIC AND WELLNESS CENTER
Entity Type:Organization
Organization Name:FUQUAY CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MIEHE
Authorized Official - Last Name:CURRIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-567-0041
Mailing Address - Street 1:1420 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-7226
Mailing Address - Country:US
Mailing Address - Phone:919-567-0041
Mailing Address - Fax:919-567-0011
Practice Address - Street 1:1420 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-7226
Practice Address - Country:US
Practice Address - Phone:919-567-0041
Practice Address - Fax:919-567-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU84112Medicare UPIN