Healthcare Provider Details
I. General information
NPI: 1104743681
Provider Name (Legal Business Name): ALIVE & SWELL CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
320 W COLEMAN BLVD STE G2
MOUNT PLEASANT SC
29464-3449
US
IV. Provider business mailing address
320 W COLEMAN BLVD STE G2
MOUNT PLEASANT SC
29464-3449
US
V. Phone/Fax
- Phone: 619-772-0962
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TYLER
HAWKE
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 619-772-0962