| Greenville Spine Institute, Llc | |
|
1190 Haywood Rd Ste B, Greenville, SC 29615-2282 | |
| (864) 631-1420 | |
| (864) 631-1459 |
| Full Name | Greenville Spine Institute, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1190 Haywood Rd Ste B, Greenville, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497041529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 3604 (South Carolina) | Primary |
| Provider Name | Kevin Parker Lewis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518253574 PECOS PAC ID: 7214106384 Enrollment ID: I20110805000320 |
| Mailing Address | Practice Location Address |
|---|---|
| Greenville Spine Institute, Llc 1190 Haywood Rd Ste B, Greenville, SC 29615-2282 Ph: (864) 631-1420 | Greenville Spine Institute, Llc 1190 Haywood Rd Ste B, Greenville, SC 29615-2282 Ph: (864) 631-1420 |
Dr. Thaddeus Modlin, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 27 S Pleasantburg Dr Ste 60, Greenville, SC 29607 Phone: 864-605-7350 Fax: 864-605-7351 | |
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