Provider Demographics
NPI:1205658051
Name:CONNECT CHIROPRACTIC
Entity type:Organization
Organization Name:CONNECT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:LANNAN
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-554-4520
Mailing Address - Street 1:251 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-7060
Mailing Address - Country:US
Mailing Address - Phone:910-222-3839
Mailing Address - Fax:
Practice Address - Street 1:251 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7060
Practice Address - Country:US
Practice Address - Phone:910-222-3839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service