Healthcare Provider Details

I. General information

NPI: 1740268762
Provider Name (Legal Business Name): EADS CHIROPRACTIC WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 HERITAGE LN
FLORENCE SC
29505-3141
US

IV. Provider business mailing address

PO BOX 1697
DARLINGTON SC
29540-1697
US

V. Phone/Fax

Practice location:
  • Phone: 843-665-7817
  • Fax: 843-665-7928
Mailing address:
  • Phone: 843-665-7817
  • Fax: 843-665-7928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2207
License Number StateSC

VIII. Authorized Official

Name: DR. DAVID A EADS
Title or Position: OWNER
Credential: DC
Phone: 843-665-7817