Healthcare Provider Details

I. General information

NPI: 1841630878
Provider Name (Legal Business Name): TREE OF LIFE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 WILDEWOOD PARK DR SUITE B
COLUMBIA SC
29223-4301
US

IV. Provider business mailing address

PO BOX 50621
COLUMBIA SC
29250-0621
US

V. Phone/Fax

Practice location:
  • Phone: 803-728-6766
  • Fax:
Mailing address:
  • Phone: 803-728-6766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3746
License Number StateSC

VIII. Authorized Official

Name: DR. TREMAIN SINGLETON
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 803-728-6766