Provider Demographics
NPI:1356648406
Name:CETD CHIROPRACTIC SERVICES P.C.
Entity Type:Organization
Organization Name:CETD CHIROPRACTIC SERVICES P.C.
Other - Org Name:CLEARVIEW CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-261-3100
Mailing Address - Street 1:1 OCEAN BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SOUTHERN SHORES
Mailing Address - State:NC
Mailing Address - Zip Code:27949-3616
Mailing Address - Country:US
Mailing Address - Phone:252-261-3100
Mailing Address - Fax:252-261-3240
Practice Address - Street 1:1 OCEAN BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:SOUTHERN SHORES
Practice Address - State:NC
Practice Address - Zip Code:27949-3616
Practice Address - Country:US
Practice Address - Phone:252-261-3100
Practice Address - Fax:252-261-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3669111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty