Provider Demographics
NPI:1427441781
Name:YADKINVILLE CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:YADKINVILLE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:P
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-679-8500
Mailing Address - Street 1:204 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-5371
Mailing Address - Country:US
Mailing Address - Phone:336-679-8500
Mailing Address - Fax:336-677-8536
Practice Address - Street 1:204 N STATE ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-5371
Practice Address - Country:US
Practice Address - Phone:336-679-8500
Practice Address - Fax:336-677-8536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty