Provider Demographics
NPI:1235945213
Name:IHM ATHLETICS LLC
Entity type:Organization
Organization Name:IHM ATHLETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC SPORTS PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:FAISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:919-886-7215
Mailing Address - Street 1:7151 OKELLY CHAPEL RD # 242
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6849
Mailing Address - Country:US
Mailing Address - Phone:919-886-7215
Mailing Address - Fax:855-590-9526
Practice Address - Street 1:7011 FAYETTEVILLE RD STE 106
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7745
Practice Address - Country:US
Practice Address - Phone:919-908-7170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IHM ATHLETICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty