Provider Demographics
NPI:1346696606
Name:GRAHAM & RANDLES CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:GRAHAM & RANDLES CHIROPRACTIC CORP
Other - Org Name:GRAHAM CHIROPRACTIC AND DISC TREATMENT CENTER PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-532-7944
Mailing Address - Street 1:601 CEDAR ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-1999
Mailing Address - Country:US
Mailing Address - Phone:252-838-8810
Mailing Address - Fax:252-364-4631
Practice Address - Street 1:601 CEDAR ST
Practice Address - Street 2:SUITE D
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-1999
Practice Address - Country:US
Practice Address - Phone:252-838-8810
Practice Address - Fax:252-364-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty