Provider Demographics
NPI:1013440940
Name:RALEIGH FAMILY AND INJURY CHIROPRACTIC
Entity Type:Organization
Organization Name:RALEIGH FAMILY AND INJURY CHIROPRACTIC
Other - Org Name:FALLS CHIROPRACTIC AND INJURY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAVIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-876-9472
Mailing Address - Street 1:6009 FALLS OF NEUSE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3525
Mailing Address - Country:US
Mailing Address - Phone:919-876-9472
Mailing Address - Fax:919-876-9478
Practice Address - Street 1:6009 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3525
Practice Address - Country:US
Practice Address - Phone:919-876-9472
Practice Address - Fax:919-876-9478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty