Provider Demographics
NPI:1316340441
Name:CONNECTED CHIROPRACTIC
Entity type:Organization
Organization Name:CONNECTED CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-550-1099
Mailing Address - Street 1:221 NC HIGHWAY 42 E
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-5281
Mailing Address - Country:US
Mailing Address - Phone:919-550-1099
Mailing Address - Fax:919-550-1902
Practice Address - Street 1:221 NC HIGHWAY 42 E
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-5281
Practice Address - Country:US
Practice Address - Phone:919-550-1099
Practice Address - Fax:919-550-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2015-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty