Healthcare Provider Details

I. General information

NPI: 1427257906
Provider Name (Legal Business Name): EKECHI NWOGA D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 CHESTERFIELD ST S
AIKEN SC
29801-7113
US

IV. Provider business mailing address

227 CHESTERFIELD ST S
AIKEN SC
29801-7113
US

V. Phone/Fax

Practice location:
  • Phone: 803-226-0231
  • Fax:
Mailing address:
  • Phone: 803-226-0231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 30405
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberDC 4093
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: