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 today at 9:16 AM.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