Provider Demographics
NPI:1629006440
Name:ST GERMAIN, VICTORIA (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:ST GERMAIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 CARMEL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-8281
Mailing Address - Country:US
Mailing Address - Phone:704-541-4747
Mailing Address - Fax:704-541-4746
Practice Address - Street 1:6303 CARMEL RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8281
Practice Address - Country:US
Practice Address - Phone:704-541-4747
Practice Address - Fax:704-541-4746
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2507171100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist