Provider Demographics
NPI:1902415771
Name:JANGRACYN CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:JANGRACYN CHIROPRACTIC, PC
Other - Org Name:AMMONS CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ZAPATA
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-774-6111
Mailing Address - Street 1:1401 GREENWAY CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-6954
Mailing Address - Country:US
Mailing Address - Phone:919-774-6111
Mailing Address - Fax:
Practice Address - Street 1:1401 GREENWAY CT
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-6954
Practice Address - Country:US
Practice Address - Phone:919-774-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty