Provider Demographics
NPI:1477618569
Name:DLO INC
Entity type:Organization
Organization Name:DLO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:910-329-0011
Mailing Address - Street 1:786 NC HIGHWAY 210 W
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3464
Mailing Address - Country:US
Mailing Address - Phone:910-270-4795
Mailing Address - Fax:
Practice Address - Street 1:786 NC HIGHWAY 210 W
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3464
Practice Address - Country:US
Practice Address - Phone:910-270-4795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC016N6OtherBCBSNC
NC89016N6Medicaid