Provider Demographics
NPI:1154388494
Name:GARNER CHIROPRACTIC & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:GARNER CHIROPRACTIC & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-779-2225
Mailing Address - Street 1:1428 AVERSBORO RD STE D
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4587
Mailing Address - Country:US
Mailing Address - Phone:919-779-2225
Mailing Address - Fax:919-779-9569
Practice Address - Street 1:1428 AVERSBORO RD STE D
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4587
Practice Address - Country:US
Practice Address - Phone:919-779-2225
Practice Address - Fax:919-779-9569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0842ROtherBLUE CROSS BLUE SHIELD
NC890842RMedicaid
36621OtherPARTNERS HEALTH INS
NC2340035OtherAETNA
2210183OtherFIRST HEALTH
614113OtherAMERICAN CHIROPRACTIC NET
2210183OtherFIRST HEALTH
=========OtherUNITED HEALTHCARE
614113OtherAMERICAN CHIROPRACTIC NET
U79731Medicare UPIN