Provider Demographics
NPI:1972033660
Name:CAROLINA BRAIN CENTER, PC
Entity type:Organization
Organization Name:CAROLINA BRAIN CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:DEBRA
Authorized Official - Last Name:DANE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-703-0207
Mailing Address - Street 1:6404 FALLS OF NEUSE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6832
Mailing Address - Country:US
Mailing Address - Phone:919-703-0207
Mailing Address - Fax:919-703-0208
Practice Address - Street 1:6404 FALLS OF NEUSE RD STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6832
Practice Address - Country:US
Practice Address - Phone:919-703-0207
Practice Address - Fax:919-703-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3817111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty