Provider Demographics
NPI:1891371712
Name:NACKLEY CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:NACKLEY CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NACKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-751-1155
Mailing Address - Street 1:1100 PARKWAY DR STE B
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-3477
Mailing Address - Country:US
Mailing Address - Phone:919-751-1155
Mailing Address - Fax:919-751-1151
Practice Address - Street 1:1100 PARKWAY DR STE B
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-3477
Practice Address - Country:US
Practice Address - Phone:919-751-1155
Practice Address - Fax:919-751-1151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty