Provider Demographics
NPI:1295802676
Name:FOX, SUZANNE LUCILLE (DC)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:LUCILLE
Last Name:FOX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:LUCILLE
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1717 LEGION RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2396
Mailing Address - Country:US
Mailing Address - Phone:919-968-4417
Mailing Address - Fax:919-968-4243
Practice Address - Street 1:1717 LEGION RD
Practice Address - Street 2:SUITE 202
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2396
Practice Address - Country:US
Practice Address - Phone:919-968-4417
Practice Address - Fax:919-968-4243
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011286-1111NN1001X
NC4015111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition