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Individual

JUSTIN WAKE BODE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
300 MAGNOLIA SQUARE CT, ABERDEEN, NC 28315-2227
(910) 695-1500
(910) 695-1505
Mailing address
300 MAGNOLIA SQUARE CT, ABERDEEN, NC 28315-2227
(910) 695-1500
(910) 695-1505

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2433
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
890829M
NC
Enumeration date
02/02/2006
Last updated
07/08/2007
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