Provider Demographics
NPI:1891802708
Name:CHIROPRACTIC CENTER OF PEMBROKE
Entity Type:Organization
Organization Name:CHIROPRACTIC CENTER OF PEMBROKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERWOOD
Authorized Official - Middle Name:F
Authorized Official - Last Name:HINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:910-521-7800
Mailing Address - Street 1:PO BOX 3028
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-3028
Mailing Address - Country:US
Mailing Address - Phone:910-521-7800
Mailing Address - Fax:910-521-7893
Practice Address - Street 1:401 E 3RD STREET
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-3028
Practice Address - Country:US
Practice Address - Phone:910-521-7800
Practice Address - Fax:910-521-7893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01035OtherGROUP