Provider Demographics
NPI:1306239199
Name:MCCORKLE CHIROPRACTIC
Entity type:Organization
Organization Name:MCCORKLE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:MCCORKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-358-6518
Mailing Address - Street 1:501 JONES FERRY RD APT K4
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2118
Mailing Address - Country:US
Mailing Address - Phone:919-358-6518
Mailing Address - Fax:
Practice Address - Street 1:501 JONES FERRY RD APT K4
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2118
Practice Address - Country:US
Practice Address - Phone:919-358-6518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty