Provider Demographics
NPI:1407226137
Name:ULLA SVANE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ULLA SVANE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ULLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SVANE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-993-6330
Mailing Address - Street 1:10633 OAK POND CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:706-993-6330
Mailing Address - Fax:
Practice Address - Street 1:13635 PROVIDENCE ROAD
Practice Address - Street 2:
Practice Address - City:WEDDINGTON
Practice Address - State:NC
Practice Address - Zip Code:28104
Practice Address - Country:US
Practice Address - Phone:706-993-6330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4218261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center