Provider Demographics
NPI:1790954121
Name:RICHARD S. PASKO, D.C., PLLC
Entity Type:Organization
Organization Name:RICHARD S. PASKO, D.C., PLLC
Other - Org Name:SEVEN LAKES CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PASKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DACBR
Authorized Official - Phone:910-673-2225
Mailing Address - Street 1:PO BOX 834
Mailing Address - Street 2:
Mailing Address - City:SEVEN LAKES
Mailing Address - State:NC
Mailing Address - Zip Code:27376-0834
Mailing Address - Country:US
Mailing Address - Phone:910-673-2225
Mailing Address - Fax:910-673-7544
Practice Address - Street 1:1064 SEVEN LAKES DR
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376
Practice Address - Country:US
Practice Address - Phone:910-673-2225
Practice Address - Fax:910-673-7544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3353111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCT46314Medicare UPIN