| |
8626 Dorchester Rd, 101, North Charleston, SC 29420-7328 | |
(843) 225-7746 | |
(843) 225-7749 |
Full Name | |
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Type | Facility |
Speciality | Neuromusculoskeletal Medicine, Sports Medicine |
Location | 8626 Dorchester Rd, North Charleston, South Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295759553 | NPI | - | NPPES |
GCH462 | Medicaid | SC | |
GP4105 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NX0100X | Chiropractor - Occupational Health | 2491 (South Carolina) | Primary |
204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 021585 (South Carolina) | Primary |
Mailing Address | Practice Location Address |
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8626 Dorchester Rd, 101, North Charleston, SC 29420-7328 Ph: (843) 225-7746 | 8626 Dorchester Rd, 101, North Charleston, SC 29420-7328 Ph: (843) 225-7746 |