Provider Demographics
NPI:1457581803
Name:SCOLIOSIS CENTER OF NORTH CAROLINA, PLLC
Entity Type:Organization
Organization Name:SCOLIOSIS CENTER OF NORTH CAROLINA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:J
Authorized Official - Last Name:CREEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-460-4546
Mailing Address - Street 1:100 PRESTON EXECUTIVE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8437
Mailing Address - Country:US
Mailing Address - Phone:919-460-4546
Mailing Address - Fax:919-467-5487
Practice Address - Street 1:100 PRESTON EXECUTIVE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8437
Practice Address - Country:US
Practice Address - Phone:919-460-4546
Practice Address - Fax:919-467-5487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty