Provider Demographics
NPI:1669627717
Name:NALL, CORTNEY DICE (DC)
Entity Type:Individual
Prefix:DR
First Name:CORTNEY
Middle Name:DICE
Last Name:NALL
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 1:3620 SHANNON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6332
Mailing Address - Country:US
Mailing Address - Phone:919-381-6960
Mailing Address - Fax:919-381-6962
Practice Address - Street 1:3620 SHANNON RD STE 102
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6332
Practice Address - Country:US
Practice Address - Phone:919-381-6960
Practice Address - Fax:919-381-6962
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010000111N00000X
PAAJ009813225100000X
NC3978111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist