Healthcare Provider Details

I. General information

NPI: 1366707853
Provider Name (Legal Business Name): WORKMAN FAMILY CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5183 CLINTON RD STE101
STEDMAN NC
28391-9523
US

IV. Provider business mailing address

5183 CLINTON RD STE101
STEDMAN NC
28391-9523
US

V. Phone/Fax

Practice location:
  • Phone: 910-482-4444
  • Fax: 910-482-4441
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3470
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3494
License Number StateNC

VIII. Authorized Official

Name: DR. LUCCUS LEE WORKMAN
Title or Position: OWNER/MEMBER
Credential: D.C.
Phone: 919-593-5809