MEDICARE: HAMSTEAD CHIROPRACTIC CENTERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3731	SC

General Provider Information

NPI Number	:	1225434731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMSTEAD CHIROPRACTIC CENTERS

Provider Business Mailing Address
First Line	:	419 SE MAIN ST
Second Line	:	SUITE 200
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-2673
Country	:	US
Telephone Number	:	864-881-3693
Fax Number	:	864-881-3693

Provider Business Practice Location Address
First Line	:	419 SE MAIN ST
Second Line	:	SUITE 200
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-2673
Country	:	US
Telephone Number	:	864-881-3693
Fax Number	:	864-881-3693

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. ALLIE SANSBURY HAMSTEAD
Credential	:	D.C.
Telephone Number	:	864-590-0845

Provider Enumeration Date	:	11/10/2014
Last Update Date	:	11/10/2014

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