Healthcare Provider Details

I. General information

NPI: 1891766267
Provider Name (Legal Business Name): MIDTOWN CHIROPRACTIC AND ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 WAKE FOREST RD
RALEIGH NC
27609-7844
US

IV. Provider business mailing address

3030 WAKE FOREST RD
RALEIGH NC
27609-7844
US

V. Phone/Fax

Practice location:
  • Phone: 919-873-2225
  • Fax: 919-873-2220
Mailing address:
  • Phone: 919-873-2225
  • Fax: 919-873-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberNC2106
License Number StateNC

VIII. Authorized Official

Name: DR. BRETT C HIGHTOWER
Title or Position: PRESIDENT
Credential: DC
Phone: 919-873-2225