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NPI Code Detail

MEDICARE: SPIZZERINCTUM, INC.

MEDICARE: SPIZZERINCTUM, INC.
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
1111N00000XChiropractor3243SC

General Provider Information

NPI Number : 1235463100
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPIZZERINCTUM, INC.
Provider Business Mailing Address
First Line : 260 GRACES WAY
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-1613
Country : US
Telephone Number : 803-736-3700
Fax Number : 803-708-7123
Provider Business Practice Location Address
First Line : 260 GRACES WAY
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-1613
Country : US
Telephone Number : 803-736-3700
Fax Number : 803-708-7123
Authorized Official
Title or Position : CEO
Name : DR. WALTER SCOTT ALLEN
Credential : D.C.
Telephone Number : 803-736-3700
Provider Enumeration Date : 09/25/2009
Last Update Date : 04/18/2016

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Directions to “SPIZZERINCTUM, INC. ” Practice Location

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