Healthcare Provider Details

I. General information

NPI: 1548337892
Provider Name (Legal Business Name): ANKANG DONG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 HWY 9 BYPASS EAST
LANCASTER SC
29720
US

IV. Provider business mailing address

539 HWY 9 BYPASS EAST
LANCASTER SC
29720
US

V. Phone/Fax

Practice location:
  • Phone: 803-286-5700
  • Fax: 803-285-6119
Mailing address:
  • Phone: 803-286-5700
  • Fax: 803-285-6119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1486
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: