Provider Demographics
NPI:1619963360
Name:MINDER, JOEY CARL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEY
Middle Name:CARL
Last Name:MINDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5601
Mailing Address - Country:US
Mailing Address - Phone:336-570-2447
Mailing Address - Fax:336-570-9307
Practice Address - Street 1:1625 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5601
Practice Address - Country:US
Practice Address - Phone:336-570-2447
Practice Address - Fax:336-570-9307
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7908324Medicaid
NC7908324Medicaid
NCU40904Medicare UPIN