Healthcare Provider Details

I. General information

NPI: 1669578332
Provider Name (Legal Business Name): COMPREHENSIVE CHIROPRACTIC CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 03/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 KILDAIRE FARM RD
CARY NC
27511-4566
US

IV. Provider business mailing address

1125 KILDAIRE FARM RD
CARY NC
27511-4566
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-7797
  • Fax: 919-467-9272
Mailing address:
  • Phone: 919-467-7797
  • Fax: 919-467-9272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1714
License Number StateNC

VIII. Authorized Official

Name: DR. IRA ASHER RUBIN
Title or Position: OWNER/PRESIDENT
Credential: D.C.
Phone: 919-467-7797