Provider Demographics
NPI:1417359118
Name:IGNITE WELLNESS CHIROPRACTIC CENTER PLLC
Entity Type:Organization
Organization Name:IGNITE WELLNESS CHIROPRACTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GARRABRANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-468-3907
Mailing Address - Street 1:5821 FARRINGTON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9901
Mailing Address - Country:US
Mailing Address - Phone:919-307-6688
Mailing Address - Fax:
Practice Address - Street 1:5821 FARRINGTON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9901
Practice Address - Country:US
Practice Address - Phone:919-307-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty