Provider Demographics
NPI:1477811453
Name:PREMIER CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:PREMIER CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-484-4141
Mailing Address - Street 1:3825 S ROXBORO ST
Mailing Address - Street 2:STE. 115
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2799
Mailing Address - Country:US
Mailing Address - Phone:919-484-4141
Mailing Address - Fax:919-484-4188
Practice Address - Street 1:3825 S ROXBORO ST
Practice Address - Street 2:STE. 115
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2799
Practice Address - Country:US
Practice Address - Phone:919-484-4141
Practice Address - Fax:919-484-4188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty