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General NPI Number Information
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NPI Number | 1063465045
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Entity Type | Organization
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Legal Business Name | MYCHIROMED, P.A.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 4012 POSTAL WAY STE A
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-3298
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Country | US
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Telephone | 843-236-6291
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Fax | 843-872-9190
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Provider Business Mailing Address
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Address Line | 4012 POSTAL WAY STE A
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-3298
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Country | US
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Telephone | 843-236-4400
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Fax | 843-481-1976
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEAL WARREN LANGE JR.
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Credential | DC
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Telephone | 843-236-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2874
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2874
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License Number State | SC
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