Provider Demographics
NPI:1346976313
Name:AZALEA CHIROPRACTIC & ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:AZALEA CHIROPRACTIC & ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-821-0104
Mailing Address - Street 1:7741 MARKET ST STE G
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9444
Mailing Address - Country:US
Mailing Address - Phone:910-821-0104
Mailing Address - Fax:910-401-1459
Practice Address - Street 1:7741 MARKET ST STE G
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9444
Practice Address - Country:US
Practice Address - Phone:865-314-9256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty