Healthcare Provider Details

I. General information

NPI: 1932316130
Provider Name (Legal Business Name): ALPHA MEDICAL & SPINAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 FOLLY RD
CHARLESTON SC
29412-2624
US

IV. Provider business mailing address

PO BOX 12999
CHARLESTON SC
29422-2999
US

V. Phone/Fax

Practice location:
  • Phone: 843-795-3056
  • Fax: 843-762-2488
Mailing address:
  • Phone: 843-556-7828
  • Fax: 843-556-8652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNETTE Y ZARO
Title or Position: OWNER
Credential: DC
Phone: 843-795-3056