Provider Demographics
NPI:1497734537
Name:FIRST CHOICE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:FIRST CHOICE CHIROPRACTIC, INC.
Other - Org Name:GEERDES CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KOREY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GEERDES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-295-0955
Mailing Address - Street 1:500 NC HIGHWAY 5 S
Mailing Address - Street 2:SUITE A
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9714
Mailing Address - Country:US
Mailing Address - Phone:910-295-0955
Mailing Address - Fax:910-295-3427
Practice Address - Street 1:500 NC HIGHWAY 5 S
Practice Address - Street 2:SUITE A
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9714
Practice Address - Country:US
Practice Address - Phone:910-295-0955
Practice Address - Fax:910-295-3427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085UPMedicaid
NC085UPOtherBLUE CROSS BLUE SHIELD
NC085UPOtherBLUE CROSS BLUE SHIELD
NCU74258Medicare UPIN