Provider Demographics
NPI:1437817251
Name:TRANSFORMATION CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:TRANSFORMATION CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-420-4887
Mailing Address - Street 1:6070 7 LKS W
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9340
Mailing Address - Country:US
Mailing Address - Phone:910-420-4887
Mailing Address - Fax:
Practice Address - Street 1:516 LONGLEAF DRIVE
Practice Address - Street 2:SEVEN LAKES WEST
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376
Practice Address - Country:US
Practice Address - Phone:910-773-1006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service