Glenn James Lundy, D.C.
Individual provider Active NPI Sports Physician Chiropractor · Wallace, NC
NPI 1992756944 · NPPES record last updated Jul 6, 2020
Key facts
- NPI
- 1992756944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Physician Chiropractor 111NS0005X
- License
- 2913 (NC)
- Practice address
- 116 N Norwood St
Wallace, NC 28466-2730 - Phone
- (910) 285-7222
- Fax
- (910) 285-7229
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2913 | NC | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ogden Family Chiropractic Inc | Past |
Accepting new patients | |
| Stoldaddy Inc. | Sports Physician | Past |
Accepting new patients |
| Family First Chiropractic Inc | Past |
Accepting new patients | |
| Blue Ridge Health and Spine, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 2913 | NC | Yes |
Addresses
Primary practice location
116 N Norwood St
Wallace, NC 28466-2730
Mailing address
116 N Norwood St Ste 6
Wallace, NC 28466-2730
Phone (910) 285-7222
Other practice location 1
2110 S 17th St
Wilmington, NC 28401-7408
Phone (910) 343-5250
Other providers in Wallace, NC
- Mary E King
- Jennifer Cavenaugh Knowles
- Courtney Lanier
- Charles Andrew Lewis II
- Liberty Home Care, LLC
- Maryann E. Luxeder
- Allison Mathis
- Victoria Baucom Matthews
- Cassandra McAllister
- Lindsey McCombie
All providers in Wallace, NC · Sports Physician Chiropractor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.