Provider Demographics
NPI:1841494747
Name:NATHANI, DICIE DAVINA (DC)
Entity type:Individual
Prefix:DR
First Name:DICIE
Middle Name:DAVINA
Last Name:NATHANI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 CREEDMOOR RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1682
Mailing Address - Country:US
Mailing Address - Phone:919-848-3333
Mailing Address - Fax:919-848-3393
Practice Address - Street 1:7101 CREEDMOOR RD
Practice Address - Street 2:SUITE 102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1682
Practice Address - Country:US
Practice Address - Phone:919-848-3333
Practice Address - Fax:919-848-3393
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor