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1655 Broad River Rd, Columbia, SC 29210-7303 | |
| (803) 772-8680 | |
| (803) 772-5241 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1655 Broad River Rd, Columbia, 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 |
|---|---|---|---|
| 1235237579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 618 (South Carolina) | Primary |
| Provider Name | Mark Coleman Shirley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1619926995 PECOS PAC ID: 6507757432 Enrollment ID: I20040322000956 |
| Provider Name | Richard C Mooneyham |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134207491 PECOS PAC ID: 8022025923 Enrollment ID: I20060317000457 |
| Mailing Address | Practice Location Address |
|---|---|
1655 Broad River Rd, Columbia, SC 29210-7303 Ph: (803) 772-8680 | 1655 Broad River Rd, Columbia, SC 29210-7303 Ph: (803) 772-8680 |
Dr. Li Huang, D.C., DILP., AC. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 128 Leisure Ln, Columbia, SC 29210 Phone: 803-750-0040 Fax: 803-750-9626 | |
Dr. Courtney Lynn Dexter, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 224 Oneil Ct Ste 21, Columbia, SC 29223 Phone: 803-788-8831 Fax: 803-788-8846 | |
Dr. Katelyn Prakash, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 3009 Millwood Ave Ste 200, Columbia, SC 29205 Phone: 803-851-5450 | |
Dr. Virginia Kaye Samuel, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 2757 Laurel St, Suite 4, Columbia, SC 29204 Phone: 803-252-4966 Fax: 803-252-1984 | |
Walter S Allen, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 260 Graces Way, Columbia, SC 29229 Phone: 803-736-3700 Fax: 803-708-7123 | |