Healthcare Provider Details

I. General information

NPI: 1417410549
Provider Name (Legal Business Name): MATTHEW HUX
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2019
Last Update Date: 04/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 BOWER PKWY STE 108
COLUMBIA SC
29212-3734
US

IV. Provider business mailing address

1200 SAINT ANDREWS RD APT 1514
COLUMBIA SC
29210-5868
US

V. Phone/Fax

Practice location:
  • Phone: 803-708-4258
  • Fax:
Mailing address:
  • Phone: 352-446-6487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4428
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: