Healthcare Provider Details

I. General information

NPI: 1194161133
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 PAVINGSTONE CT
EFFINGHAM SC
29541-4932
US

IV. Provider business mailing address

2920 PAVINGSTONE CT
EFFINGHAM SC
29541-4932
US

V. Phone/Fax

Practice location:
  • Phone: 910-894-3641
  • Fax:
Mailing address:
  • Phone: 910-894-3641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2702
License Number StateSC

VIII. Authorized Official

Name: DR. CHADWICK LEE WHITE
Title or Position: PRESIDENT
Credential: DC
Phone: 910-894-3641