Provider Demographics
NPI:1699029215
Name:DEHAMMER
Entity Type:Organization
Organization Name:DEHAMMER
Other - Org Name:HAMMER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMOCKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-735-2205
Mailing Address - Street 1:138 S FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNTY
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6971
Mailing Address - Country:US
Mailing Address - Phone:252-443-0950
Mailing Address - Fax:
Practice Address - Street 1:138 S FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNTY
Practice Address - State:NC
Practice Address - Zip Code:27801-6971
Practice Address - Country:US
Practice Address - Phone:252-443-0950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty