Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1401 | NC |
NPI | 1437493434 |
---|---|
Provider Name | Dr. Joseph S Siragusa |
First Address | Wake Forest, NC 27587-3929 |
Second Address | Wake Forest, NC 27587-3929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2012 |
Last Update Date | 15/11/2012 |