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WILLIS CHIRO MED OF MB NPI 1649331000


NPI Information

NPI: 1649331000
Provider Name: WILLIS CHIRO MED OF MB

Doing Business As: WILLIS CHIROMED

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
1665 GLENNS BAY RD
SURFSIDE BEACH, SC
ZIP 29575
Phone: (843) 215-2324
Get Directions

WILLIS CHIRO MED OF MB is a chiropractor in Surfside Beach, 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. WILLIS CHIRO MED OF MB NPI is 1649331000. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Willis Chiromed.

The provider's business location address is:

1665 GLENNS BAY RD
SURFSIDE BEACH, SC
ZIP 29575-836
Phone: (843) 215-2324
Fax: (843) 215-0541

The provider's authorized official is Charles T Rogers .
The authorized official title is President and has the following contact phone number (843) 215-2324.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 5/30/2008.


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
1111N00000XChiropractor2486SOUTH 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
15316MEDICARE PINSOUTH CAROLINA
2CH2486MEDICAIDSOUTH 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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