Organization
LISSENDEN CHIROPRACTIC CENTER, PC
Active
Other names
'Alternative Health Clinic' and 'SportsMED'
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF W LISSENDEN D.C. (CHIROPRACTOR)
(336) 218-0094
Entity
Organization
Contact information
Practice address
4411 HIGH POINT RD, SUITE 117, GREENSBORO, NC 27407-4314
(336) 218-0094
(336) 218-7079
Mailing address
4411 HIGH POINT RD, SUITE 117, GREENSBORO, NC 27407-4314
(336) 218-0094
(336) 218-7079
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1194
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085XH
BLUE CROSS BLUE SHIELD
NC
01
—
609865
ACN
NC
Enumeration date
11/01/2006
Last updated
08/22/2020
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