Provider Demographics
NPI:1659456960
Name:CELESTE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:CELESTE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CELESTE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-848-8812
Mailing Address - Street 1:186 WIND CHIME CT
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6486
Mailing Address - Country:US
Mailing Address - Phone:919-848-8812
Mailing Address - Fax:919-848-8812
Practice Address - Street 1:186 WIND CHIME CT
Practice Address - Street 2:SUITE 104
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6486
Practice Address - Country:US
Practice Address - Phone:919-848-8812
Practice Address - Fax:919-848-8812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1457302929OtherINDIVIDUAL NPI