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General NPI Number Information
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NPI Number | 1922167238
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Entity Type | Organization
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Legal Business Name | DURHAM CHIROPRACTIC ACUPUNCTURE CLINIC PC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5201 SILAS CREEK PKWY
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City | WINSTON SALEM
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State | NC
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Zip | 27106-5526
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Country | US
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Telephone | 336-765-7620
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Fax | 336-765-3801
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Provider Business Mailing Address
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Address Line | 5201 SILAS CREEK PKWY
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City | WINSTON SALEM
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State | NC
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Zip | 27106-5526
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Country | US
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Telephone | 336-765-7620
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Fax | 336-765-3801
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CYNTHIA SUTTON DURHAM
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Credential | D.C.
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Telephone | 336-765-7620
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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 | 2689
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License Number State | NC
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