Provider Demographics
NPI:1528109626
Name:CHIROPRACTIC ADVANTAGE OF CARY, PA
Entity type:Organization
Organization Name:CHIROPRACTIC ADVANTAGE OF CARY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAAT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-759-9177
Mailing Address - Street 1:605A N SPENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4263
Mailing Address - Country:US
Mailing Address - Phone:919-759-9177
Mailing Address - Fax:919-759-9177
Practice Address - Street 1:605A N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4263
Practice Address - Country:US
Practice Address - Phone:919-759-9177
Practice Address - Fax:919-759-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2792111N00000X
NC2641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890836HMedicaid
NC89085PCMedicaid
NC89085PCMedicaid
NCU74462Medicare UPIN
NCU78959Medicare UPIN
NC2454043BMedicare ID - Type Unspecified