Provider Demographics
NPI:1497084214
Name:NORTH RALEIGH WELLNESS, PLLC
Entity Type:Organization
Organization Name:NORTH RALEIGH WELLNESS, PLLC
Other - Org Name:NORTH RALEIGH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:919-845-0200
Mailing Address - Street 1:8414 FALLS OF NEUSE RD
Mailing Address - Street 2:SUITE 104A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3544
Mailing Address - Country:US
Mailing Address - Phone:919-845-0200
Mailing Address - Fax:919-845-0204
Practice Address - Street 1:8414 FALLS OF NEUSE RD
Practice Address - Street 2:SUITE 104A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3544
Practice Address - Country:US
Practice Address - Phone:919-845-0200
Practice Address - Fax:919-845-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890834HMedicaid
NC890834HMedicaid