MEDICARE: DR. DICIE DAVINA NATHANI DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4017	NC

General Provider Information

NPI Number	:	1841494747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DICIE DAVINA NATHANI DC

Provider Business Mailing Address
First Line	:	7101 CREEDMOOR RD
Second Line	:	SUITE 102
City	:	RALEIGH
State	:	NC
Zip	:	27613-1682
Country	:	US
Telephone Number	:	919-848-3333
Fax Number	:	919-848-3393

Provider Business Practice Location Address
First Line	:	7101 CREEDMOOR RD
Second Line	:	SUITE 102
City	:	RALEIGH
State	:	NC
Zip	:	27613-1682
Country	:	US
Telephone Number	:	919-848-3333
Fax Number	:	919-848-3393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	03/19/2018

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