Organization · Type 2 NPI

Healthsource of Lake Boone Trail, PLLC

Chiropractor · Raleigh, NC

NPI number 1255616611 Active

Practice location

4025 Lake Boone Trl, Suite 120
Raleigh, NC 27607-2986

Call (919) 785-9191 Map

Fax (919) 785-9193

Mailing address

4025 Lake Boone Trail, Suite 120
Raleigh, NC 27607-2986

Specialties and licenses

TaxonomyCodeLicense
Chiropractor Primary 111N00000X3364 (NC)

Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

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About NPI 1255616611

Healthsource of Lake Boone Trail, PLLC's National Provider Identifier is 1255616611, issued on Oct 18, 2011. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Raleigh, NC. The record was last updated on Nov 10, 2011.