Healthcare Provider Details

I. General information

NPI: 1255447066
Provider Name (Legal Business Name): STEPHEN NORWOOD SKIPPER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 05/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W. CAROLINA AVE.
HARTSVILLE SC
29550
US

IV. Provider business mailing address

600 W CAROLINA AVE
HARTSVILLE SC
29550-4410
US

V. Phone/Fax

Practice location:
  • Phone: 843-383-2340
  • Fax: 843-383-2341
Mailing address:
  • Phone: 843-383-2340
  • Fax: 843-383-2341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3167
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: