Provider Demographics
NPI:1215096334
Name:PORT CITY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:PORT CITY CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-343-9500
Mailing Address - Street 1:3926 MARKET ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1449
Mailing Address - Country:US
Mailing Address - Phone:910-343-9500
Mailing Address - Fax:910-343-9599
Practice Address - Street 1:3926 MARKET ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1449
Practice Address - Country:US
Practice Address - Phone:910-343-9500
Practice Address - Fax:910-343-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085H6Medicaid
NC641817OtherACN
NC085H6OtherBCBS
NCU92205AMedicare UPIN
NC2455181AMedicare ID - Type Unspecified