Provider Demographics
NPI:1497925762
Name:CHIROPRACTIC CENTER OF WILMINGTON, INC
Entity Type:Organization
Organization Name:CHIROPRACTIC CENTER OF WILMINGTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:R
Authorized Official - Last Name:FOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-313-6959
Mailing Address - Street 1:609 SHIPYARD BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6562
Mailing Address - Country:US
Mailing Address - Phone:910-313-6959
Mailing Address - Fax:910-313-6960
Practice Address - Street 1:609 SHIPYARD BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6562
Practice Address - Country:US
Practice Address - Phone:910-313-6959
Practice Address - Fax:910-313-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty