MEDICARE: GREENMAN CHIROPRACTIC AND WELLNESS, LLC

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	2987	SC

General Provider Information

NPI Number	:	1447630934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENMAN CHIROPRACTIC AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	3404 SALTERBECK CT
Second Line	:	SUITE 201
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7119
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3404 SALTERBECK CT
Second Line	:	SUITE 201
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7119
Country	:	US
Telephone Number	:	843-284-8115
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADAM GREENMAN
Credential	:
Telephone Number	:	843-284-8115

Provider Enumeration Date	:	06/01/2015
Last Update Date	:	06/01/2015

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