Provider Demographics
NPI:1194885988
Name:CHIROPRACTIC WELLNESS CENTER OF CARY, PLLC
Entity type:Organization
Organization Name:CHIROPRACTIC WELLNESS CENTER OF CARY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-439-2539
Mailing Address - Street 1:1155 KILDAIRE FARM RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4581
Mailing Address - Country:US
Mailing Address - Phone:919-439-2539
Mailing Address - Fax:
Practice Address - Street 1:1155 KILDAIRE FARM RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4581
Practice Address - Country:US
Practice Address - Phone:919-439-2539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1912993783OtherNPI TYPE 1
NC1194885988OtherNPI TYPE II
NC1194885988OtherNPI TYPE II