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General NPI Number Information
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NPI Number | 1063218055
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Entity Type | Organization
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Legal Business Name | INNATE HOLDINGS LLC
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 8 DAVIS KEATS DR
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City | GREENVILLE
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State | SC
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Zip | 29607-6509
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Country | US
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Telephone | 864-214-5010
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Fax |
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Provider Business Mailing Address
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Address Line | 607 W 5TH NORTH ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6166
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Country | US
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Telephone | 843-873-0011
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. QUINTEZ JUWAN HILL
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Credential | DC
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Telephone | 864-367-5104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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