Provider Demographics
NPI:1366707853
Name:WORKMAN FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:WORKMAN FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCCUS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-593-5809
Mailing Address - Street 1:5183 CLINTON RD
Mailing Address - Street 2:STE101
Mailing Address - City:STEDMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28391-9523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5183 CLINTON RD
Practice Address - Street 2:STE101
Practice Address - City:STEDMAN
Practice Address - State:NC
Practice Address - Zip Code:28391-9523
Practice Address - Country:US
Practice Address - Phone:910-482-4444
Practice Address - Fax:910-482-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3470111N00000X
NC3494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1225133515OtherINDIVIDUAL NPI
NC1487789277OtherINDIVIDUAL NPI
NC7908968Medicaid
NC2458052Medicare PIN
1225133515OtherINDIVIDUAL NPI
NC2459343Medicare PIN