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WALLACE CHIROPRACTIC AND SPINAL REHAB LLC NPI 1013188531


NPI Information

NPI: 1013188531
Provider Name: WALLACE CHIROPRACTIC AND SPINAL REHAB, LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
263 KELLEY ST
SUITE 100
LAKE CITY, SC
ZIP 29560
Phone: (843) 394-8274
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WALLACE CHIROPRACTIC AND SPINAL REHAB, LLC is a chiropractor in Lake City, SC. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. WALLACE CHIROPRACTIC AND SPINAL REHAB, LLC NPI is 1013188531. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

263 KELLEY ST
SUITE 100
LAKE CITY, SC
ZIP 29560-472
Phone: (843) 394-8274
Fax: (843) 394-1604

The provider's authorized official is Crystal Knight .
The authorized official title is Ca and has the following contact phone number (843) 394-8274.

The enumeration date for this NPI number is 3/13/2008 and was last updated on 6/20/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor1873SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16481000001MEDICARE NSCSOUTH CAROLINA
2GCH113MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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