Healthcare Provider Details

I. General information

NPI: 1497684104
Provider Name (Legal Business Name): ALIX DAWN HIMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 HAMPTON RIDGE DR
GREER SC
29651-5836
US

IV. Provider business mailing address

308 HAMPTON RIDGE DR
GREER SC
29651-5836
US

V. Phone/Fax

Practice location:
  • Phone: 864-414-3055
  • Fax:
Mailing address:
  • Phone: 864-414-3055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13807
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: