Provider Demographics
NPI:1982269270
Name:UNIVERSITY CHIROPRACTIC OFFICE CORPORATION
Entity type:Organization
Organization Name:UNIVERSITY CHIROPRACTIC OFFICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:FRATELLONE
Authorized Official - Last Name:SENVIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-493-1940
Mailing Address - Street 1:2717 WESTERN BYP STE 1019
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5770
Mailing Address - Country:US
Mailing Address - Phone:919-730-3895
Mailing Address - Fax:
Practice Address - Street 1:2717 WESTERN BYP STE 1019
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5770
Practice Address - Country:US
Practice Address - Phone:919-493-1940
Practice Address - Fax:919-237-2770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790058840OtherPERSONAL INDIVIUAL NPI #