Provider Demographics
NPI:1801048228
Name:CHIROPRACTIC CAFE, PLLC
Entity type:Organization
Organization Name:CHIROPRACTIC CAFE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:SNOWDEN
Authorized Official - Last Name:PAGANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-845-5553
Mailing Address - Street 1:8321 SIX FORKS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2107
Mailing Address - Country:US
Mailing Address - Phone:919-845-5553
Mailing Address - Fax:919-845-5505
Practice Address - Street 1:8321 SIX FORKS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2107
Practice Address - Country:US
Practice Address - Phone:919-845-5553
Practice Address - Fax:919-845-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty