Healthcare Provider Details

I. General information

NPI: 1356889554
Provider Name (Legal Business Name): DURHAM CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2017
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 MARTIN LUTHER KING PKWY STE 107
DURHAM NC
27707-3586
US

IV. Provider business mailing address

1802 MARTIN LUTHER KING PKWY SUITE 107
DURHAM NC
27707-3586
US

V. Phone/Fax

Practice location:
  • Phone: 919-401-5061
  • Fax:
Mailing address:
  • Phone: 919-401-5061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberNC1773
License Number StateNC

VIII. Authorized Official

Name: DR. RICHARD A ESSMAN JR.
Title or Position: OWNER
Credential: DC
Phone: 919-401-5061