| Whole Life Chiropractic Pc | |
|
5410 Page Rd Ste 3 Durham NC 27703-8230 | |
| (919) 474-8400 | |
| Not Available |
| Full Name | Whole Life Chiropractic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5410 Page Rd Ste 3, Durham, North Carolina |
| Authorized Official Name and Position | Dolphus Allen Thacker (OWNER) |
| Authorized Official Contact | 9194748400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Life Chiropractic Pc 5410 Page Rd Ste 3 Durham NC 27703-8230 Ph: (919) 474-8400 | Whole Life Chiropractic Pc 5410 Page Rd Ste 3 Durham NC 27703-8230 Ph: (919) 474-8400 |
| NPI Number | 1568088672 |
|---|---|
| Provider Enumeration Date | 06/24/2020 |
| Last Update Date | 06/24/2020 |
| Medicare PECOS PAC ID | 6800219189 |
|---|---|
| Medicare Enrollment ID | O20200702002131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568088672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Dolphus Allen Thacker |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1588963540 PECOS PAC ID: 2769652767 Enrollment ID: I20110831000045 |
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