=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003614702
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAMPTON COUNTY CHIROPRACTIC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2025
-----------------------------------------------------
Last Update Date | 03/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34 MAIN ST
-----------------------------------------------------
City | VARNVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29944-9651
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-539-1111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 64
-----------------------------------------------------
City | VARNVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29944-0064
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-539-1111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. BRIANNE GALLAGHER
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 843-539-1111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------