Provider Demographics
NPI:1669779203
Name:SANDEZ FAMILY CHIROPRACTIC & WELLNESS CENTER, PLLC
Entity type:Organization
Organization Name:SANDEZ FAMILY CHIROPRACTIC & WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:SANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-535-3091
Mailing Address - Street 1:1616 EVANS ROAD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-9653
Mailing Address - Country:US
Mailing Address - Phone:919-535-3091
Mailing Address - Fax:919-535-3099
Practice Address - Street 1:1616 EVANS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-9653
Practice Address - Country:US
Practice Address - Phone:919-535-3091
Practice Address - Fax:919-535-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty