Healthcare Provider Details

I. General information

NPI: 1366401697
Provider Name (Legal Business Name): FIRST CHOICE CHIROPRACTIC AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 GENTRY MEMORIAL HWY SUITE A
PICKENS SC
29671-9426
US

IV. Provider business mailing address

2525 GENTRY MEMORIAL HWY SUITE A
PICKENS SC
29671-9426
US

V. Phone/Fax

Practice location:
  • Phone: 864-878-0615
  • Fax: 864-878-0667
Mailing address:
  • Phone: 864-878-0615
  • Fax: 864-878-0667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1613
License Number StateSC

VIII. Authorized Official

Name: MRS. BARBARA ANN YERGEAU
Title or Position: OFFICE MANAGER
Credential:
Phone: 864-878-0615