MEDICARE: CHIROPRACTIC IN MOTION

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

General Provider Information

NPI Number	:	1679049449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC IN MOTION

Provider Business Mailing Address
First Line	:	4000 FABER PLACE DR STE 300
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29405-8587
Country	:	US
Telephone Number	:	864-415-8651
Fax Number	:	843-640-3098

Provider Business Practice Location Address
First Line	:	4000 FABER PLACE DR STE 300
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29405-8587
Country	:	US
Telephone Number	:	864-415-8651
Fax Number	:	843-640-3098

Authorized Official
Title or Position	:	MANAGER
Name	:	MORGAN ILONCAIE
Credential	:	DC
Telephone Number	:	864-415-8651

Provider Enumeration Date	:	10/19/2018
Last Update Date	:	01/10/2019

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Directions to “CHIROPRACTIC IN MOTION ” Practice Location

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