Healthcare Provider Details
I. General information
NPI: 1639901440
Provider Name (Legal Business Name): SUNSHINE CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2024
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9420 PHILBECK LN
WAKE FOREST NC
27587-1608
US
IV. Provider business mailing address
9420 PHILBECK LN
WAKE FOREST NC
27587-3603
US
V. Phone/Fax
- Phone: 813-966-7111
- Fax:
- Phone: 813-731-6464
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ELIZABETH
KIRBY
Title or Position: OWNER
Credential: DC
Phone: 813-731-6464