Provider Demographics
NPI:1831573112
Name:CAROLINA HEAD AND SPINE CLINIC OF CHIROPRACTIC,PA
Entity type:Organization
Organization Name:CAROLINA HEAD AND SPINE CLINIC OF CHIROPRACTIC,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SAELI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-246-9497
Mailing Address - Street 1:3001 ACADEMY ROAD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-246-9497
Mailing Address - Fax:919-403-2917
Practice Address - Street 1:3001 ACADEMY ROAD
Practice Address - Street 2:SUITE 230
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-246-9497
Practice Address - Fax:919-403-2917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200002586073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty