Provider Demographics
NPI:1144312117
Name:CHICOINE, JEFFREY ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:CHICOINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 BATTLEGROUND AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-1929
Mailing Address - Country:US
Mailing Address - Phone:336-545-7770
Mailing Address - Fax:336-545-7717
Practice Address - Street 1:2509 BATTLEGROUND AVE STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-1929
Practice Address - Country:US
Practice Address - Phone:336-545-7770
Practice Address - Fax:336-545-7717
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0829HOtherBCBS OF NC
NC890829HMedicaid
NC890829HMedicaid