OrganizationTeam Chiropractic & Sports Medicine, PaChiropractorChiropractic ProvidersPractice Address309-199 W Millbrook Rd, Raleigh, NC 27609-4385(919) 788-8881PECOS EnrollmentBased on the most recent information from CMS, provider Team Chiropractic & Sports Medicine, Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1316086366Provider TypeOrganizationFull NameTeam Chiropractic & Sports Medicine, PaSubpartNoEnumeration Date2/6/2007Last Updated8/22/2007Contact InformationPractice LocationPractice Address309-199 W Millbrook Rd, Raleigh, NC 27609-4385Phone(919) 788-8881Fax(919) 788-8818Mailing LocationMailing Address309-199 W Millbrook Rd, Raleigh, NC 27609-4385Phone(919) 788-8881Fax(919) 788-8818Authorized OfficialNameDodd, Lawrence D (Chiropractor)Phone(919) 788-8881Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicense2172North CarolinaProvider IdentifiersIDDescriptionIssuerID2346483DescriptionOtherIssuerMEDICARE GROUP NUMBERNorth CarolinaID7908316DescriptionMedicaidIssuerUnlistedNorth CarolinaID0201UDescriptionOtherIssuerBCBS GROUP NUMBERNorth CarolinaID08316DescriptionOtherIssuerBCBS INDIVIDUAL DODDNorth CarolinaID790201UDescriptionOtherIssuerMEDICAID GROUP NUMBERNorth Carolina