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General NPI Number Information
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NPI Number | 1083674634
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Entity Type | Organization
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Legal Business Name | WOODRUFF CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 05/24/2012
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Provider Practice Location Address
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Address Line | 1019 PHYSICIANS DR
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City | CHARLESTON
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State | SC
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Zip | 29414-5746
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Country | US
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Telephone | 843-571-5366
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Fax | 843-571-5659
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Provider Business Mailing Address
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Address Line | 1019 PHYSICIANS DR
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City | CHARLESTON
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State | SC
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Zip | 29414-5746
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Country | US
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Telephone | 843-571-5366
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Fax | 843-571-5659
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | STEPHANIE B WOODRUFF
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Credential | DC
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Telephone | 843-571-5366
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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 | 2996
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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 | 2005
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 17193
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License Number State | SC
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