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Organization

FAYETTEVILLE CHIROPRACTIC

Active
Other names
Fayetteville Family Chiropractic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEROME E FONKE D.C. (PRESIDENT)
(910) 484-5999
Entity
Organization

Contact information

Practice address
205 OWEN DR, FAYETTEVILLE, NC 28304-3409
(910) 484-5999
(910) 484-2523
Mailing address
424 GRAYLYN PL, FAYETTEVILLE, NC 28314-2630
(910) 864-8180

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1875
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0840G
BCBS OF NC
NC
05
890823W
NC
Enumeration date
09/20/2006
Last updated
10/13/2015
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