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General NPI Number Information
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NPI Number | 1477120806
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Entity Type | Organization
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Legal Business Name | CENTERED CHIROPRACTIC PA
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 8928 US 70 BUS HWY W STE 700
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City | CLAYTON
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State | NC
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Zip | 27520-4847
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Country | US
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Telephone | 919-553-5505
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Fax | 919-553-9909
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Provider Business Mailing Address
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Address Line | 8928 US 70 BUS HWY W STE 700
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City | CLAYTON
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State | NC
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Zip | 27520-4847
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Country | US
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Telephone | 919-553-5505
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Fax | 919-553-9909
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Authorized Official
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Title or Position | OWNER
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Name | DR. JORDAN BONHAM
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Credential | DC
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Telephone | 412-251-8573
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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 |
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License Number State |
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