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General NPI Number Information
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NPI Number | 1881945897
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Entity Type | Organization
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Legal Business Name | BODY LOGIC CHIROPRACTIC CENTER, PLLC
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 6320 ANGUS DR SUITE D
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City | RALEIGH
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State | NC
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Zip | 27617-4756
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Country | US
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Telephone | 919-789-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 6320 ANGUS DR SUITE D
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City | RALEIGH
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State | NC
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Zip | 27617-4756
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Country | US
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Telephone | 919-789-3599
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. LINDA A FOGLIA
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Credential | DC
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Telephone | 919-789-3599
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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 | 3647
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License Number State | NC
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