Deese & Locklear Chiropractic Center, PLLC

Organization Active NPI Chiropractor · Pembroke, NC

NPI 1366635989 · NPPES record last updated Oct 27, 2016

Key facts

NPI
1366635989
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
2915 (NC)
Legal business name
DEESE & LOCKLEAR CHIROPRACTIC CENTER, PLLC
Practice address
812 Candy Park Rd
Suite 6103
Pembroke, NC 28372-9129
Phone
(910) 521-3093
Fax
(910) 521-3095
NPI assigned
Aug 27, 2007
Organization subpart
No

Authorized official

Name
Ms. Lora Kay Oxendine
Title
Office Manager
Phone
(910) 521-3093

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080604000193 NC Part B Supplier - Clinic/Group Practice 8729158605 Receives reassigned benefits from 2 practitioners
Practice locations: Pembroke, NC

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 2915 NC Yes

Addresses

Primary practice location

812 Candy Park Rd
Suite 6103
Pembroke, NC 28372-9129

Mailing address

PO Box 2219
Pembroke, NC 28372-2219
Phone (910) 521-3093

Other identifiers

IdentifierTypeStateIssuer
5950376MedicaidNC

Other providers in Pembroke, NC

All providers in Pembroke, NC · Chiropractor in North Carolina

Sources for this page

Verify at the official NPI Registry.