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General NPI Number Information
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NPI Number | 1013440940
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Entity Type | Organization
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Legal Business Name | RALEIGH FAMILY AND INJURY CHIROPRACTIC
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 6009 FALLS OF NEUSE RD
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City | RALEIGH
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State | NC
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Zip | 27609-3525
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Country | US
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Telephone | 919-876-9472
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Fax | 919-876-9478
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Provider Business Mailing Address
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Address Line | 6009 FALLS OF NEUSE RD
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City | RALEIGH
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State | NC
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Zip | 27609-3525
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Country | US
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Telephone | 919-876-9472
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Fax | 919-876-9478
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | RICHARD A LAVIANO
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Credential | D.C
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Telephone | 919-876-9472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4428
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License Number State | NC
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