Provider Demographics
NPI:1184792574
Name:WORKMAN CHIROPRACTIC, INC
Entity type:Organization
Organization Name:WORKMAN CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-851-0980
Mailing Address - Street 1:208 ASHVILLE AVE
Mailing Address - Street 2:SUITE 30
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6678
Mailing Address - Country:US
Mailing Address - Phone:919-851-0980
Mailing Address - Fax:919-851-0071
Practice Address - Street 1:208 ASHVILLE AVENUE
Practice Address - Street 2:SUITE 30
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6678
Practice Address - Country:US
Practice Address - Phone:919-851-0980
Practice Address - Fax:919-851-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085P1Medicaid
NC668250OtherACN
NC085P1OtherBLUE CROSS BLUE SHIELD
NC2341488Medicare PIN
NC668250OtherACN