Provider Demographics
NPI:1629365341
Name:COLUMBIA CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:COLUMBIA CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRABBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-482-4499
Mailing Address - Street 1:187 LA KEISER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NC
Mailing Address - Zip Code:27925
Mailing Address - Country:US
Mailing Address - Phone:252-796-2225
Mailing Address - Fax:252-796-2227
Practice Address - Street 1:187 LA KEISER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:NC
Practice Address - Zip Code:27932
Practice Address - Country:US
Practice Address - Phone:252-796-2225
Practice Address - Fax:252-796-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty