Healthcare Provider Details

I. General information

NPI: 1932191384
Provider Name (Legal Business Name): JOSEPH SCOTT HAVEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 MAIN ST STE D
HILTON HEAD ISLAND SC
29926-1754
US

IV. Provider business mailing address

92 MAIN ST STE D
HILTON HEAD ISLAND SC
29926-1754
US

V. Phone/Fax

Practice location:
  • Phone: 843-342-3333
  • Fax: 843-423-3367
Mailing address:
  • Phone: 843-342-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2079
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: