Healthcare Provider Details

I. General information

NPI: 1740760248
Provider Name (Legal Business Name): ACUPUNCTURE AND CHIROPRACTIC CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 08/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 BROAD ST
DURHAM NC
27705-4143
US

IV. Provider business mailing address

1019 BROAD ST
DURHAM NC
27705-4143
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0009
  • Fax: 919-286-1909
Mailing address:
  • Phone: 919-286-0009
  • Fax: 919-286-1909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1039
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number272
License Number StateNC

VIII. Authorized Official

Name: DR. SPIRO N COMIS
Title or Position: PRESIDENT
Credential: DC
Phone: 919-286-0009