Provider Demographics
NPI:1487796108
Name:WASHINGTON CHIROPRACTIC GROUP, PC
Entity type:Organization
Organization Name:WASHINGTON CHIROPRACTIC GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRABBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-482-4499
Mailing Address - Street 1:920 HACKNEY AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-4254
Mailing Address - Country:US
Mailing Address - Phone:252-975-4600
Mailing Address - Fax:
Practice Address - Street 1:920 HACKNEY AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4254
Practice Address - Country:US
Practice Address - Phone:252-975-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty