Jennifer Ann Al Ghuraibawi, D.C.

Individual provider Active NPI Chiropractor · Wake Forest, NC

NPI 1861692220 · NPPES record last updated May 24, 2021

Key facts

NPI
1861692220
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
4524 (NC)
Practice address
843 Wake Forest Business Park Ste 102
Wake Forest, NC 27587-6578
Phone
(919) 600-1725
Fax
(919) 573-9691
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
001690CTMDClinical Psychologist
X0009079NYMDChiropractor
4524NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bethel Chiropractic and Sports Therapy, LLC Chiropractor Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001690 CT
Chiropractor 111N00000X 4524 NC Yes
Chiropractor 111N00000X X0009079 NY

Addresses

Primary practice location

843 Wake Forest Business Park Ste 102
Wake Forest, NC 27587-6578

Mailing address

13024 US Highway 70W
Ste 101
Clayton, NC 27520
Phone (919) 600-1725

Other providers in Wake Forest, NC

All providers in Wake Forest, NC · Chiropractor in North Carolina

Sources for this page

Verify at the official NPI Registry.