Healthcare Provider Details

I. General information

NPI: 1669716007
Provider Name (Legal Business Name): CHRISTOPHER ALLEN SHUMATE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4207 SEA MOUNTAIN HWY SUITE-B
LITTLE RIVER SC
29566-6843
US

IV. Provider business mailing address

4207 SEA MOUNTAIN HWY SUITE-B
LITTLE RIVER SC
29566-6843
US

V. Phone/Fax

Practice location:
  • Phone: 843-399-8840
  • Fax: 843-399-8841
Mailing address:
  • Phone: 843-399-8840
  • Fax: 843-399-8841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3786
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number3786
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: