Healthcare Provider Details
I. General information
NPI: 1518979020
Provider Name (Legal Business Name): PATRICK C MARTIN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/13/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4100 HOLMESTOWN RD UNIT C
MYRTLE BEACH SC
29588-4717
US
IV. Provider business mailing address
8127 TIMBER RIDGE RD
CONWAY SC
29526-9006
US
V. Phone/Fax
- Phone: 854-252-7799
- Fax:
- Phone: 854-252-7799
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2851 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: