Provider Demographics
NPI:1720346885
Name:DENAMUR CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:DENAMUR CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DENAMUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-633-3030
Mailing Address - Street 1:414 N FAYETTEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-4727
Mailing Address - Country:US
Mailing Address - Phone:336-633-3030
Mailing Address - Fax:336-633-3020
Practice Address - Street 1:414 N FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4727
Practice Address - Country:US
Practice Address - Phone:336-633-3030
Practice Address - Fax:336-633-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2205261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890833WMedicaid
NC890833WMedicaid