Organization
CRABTREE CHIROPRACTIC CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES B KUBASKO DC (OWNER)
(919) 781-8830
Entity
Organization
Contact information
Practice address
4517 LEAD MINE RD, RALEIGH, NC 27612-3326
(919) 781-8830
(919) 781-1678
Mailing address
4517 LEAD MINE RD, RALEIGH, NC 27612-3326
(919) 781-8830
(919) 781-1678
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NC
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0821F
BLUE CROSS BLUE SHIELD
NC
05
—
890821F
—
NC
Enumeration date
07/19/2006
Last updated
07/10/2009
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