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General NPI Number Information
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NPI Number | 1710093307
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Entity Type | Organization
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Legal Business Name | RALEIGH SPECIFIC CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 7721 SIX FORKS RD STE 138
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City | RALEIGH
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State | NC
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Zip | 27615-5014
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Country | US
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Telephone | 919-846-7004
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Fax | 919-846-0320
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Provider Business Mailing Address
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Address Line | 7721 SIX FORKS RD STE 138
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City | RALEIGH
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State | NC
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Zip | 27615-5014
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Country | US
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Telephone | 919-846-7004
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Fax | 919-846-0320
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Authorized Official
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Title or Position | OWNER/OFFICE MANAGER
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Name | DR. JILL RAE WINGET
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Credential | D.C.
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Telephone | 919-846-7004
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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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