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General NPI Number Information
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NPI Number | 1154108991
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Entity Type | Organization
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Legal Business Name | ADVANCED WELLNESS SOLUTIONS OF THE UPSTATE
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 120 E CURTIS ST STE A
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-2620
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Country | US
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Telephone | 864-641-3183
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Fax |
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Provider Business Mailing Address
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Address Line | 19 KNOTTY PINE CT
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City | FOUNTAIN INN
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State | SC
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Zip | 29644-9257
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Country | US
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Telephone | 864-283-2710
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. CHRISTOPHER DOYLE
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Credential | DC
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Telephone | 864-283-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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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 |
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License Number State |
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