Provider Demographics
NPI:1780722355
Name:ADVANCED CHIROPRACTIC HEALTH CENTER PLLC
Entity type:Organization
Organization Name:ADVANCED CHIROPRACTIC HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TWOMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-401-9099
Mailing Address - Street 1:3626 SHANNON RD
Mailing Address - Street 2:STE# 102
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3596
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3626 SHANNON RD
Practice Address - Street 2:STE# 102
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3596
Practice Address - Country:US
Practice Address - Phone:919-401-9099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU97065Medicare UPIN
NC2456795Medicare ID - Type Unspecified