Provider Demographics
NPI:1346577038
Name:JENA FRIEDEL DC PC
Entity Type:Organization
Organization Name:JENA FRIEDEL DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-643-2273
Mailing Address - Street 1:410 MILLSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-8778
Mailing Address - Country:US
Mailing Address - Phone:919-643-2273
Mailing Address - Fax:919-643-2272
Practice Address - Street 1:410 MILLSTONE DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8778
Practice Address - Country:US
Practice Address - Phone:919-643-2273
Practice Address - Fax:919-643-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3125111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085NHOtherBCBS
NC085NHOtherBCBS
NC85085NHMedicaid