Provider Demographics
NPI:1386250124
Name:NICOL CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:NICOL CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:NICOL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-704-7008
Mailing Address - Street 1:7011 FAYETTEVILLE RD STE 106B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7745
Mailing Address - Country:US
Mailing Address - Phone:919-564-8663
Mailing Address - Fax:
Practice Address - Street 1:7011 FAYETTEVILLE RD STE 106B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7745
Practice Address - Country:US
Practice Address - Phone:919-564-8663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy