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General NPI Number Information
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NPI Number | 1154462612
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Entity Type | Organization
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Legal Business Name | SEA ONE FAMILY CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 1211 44TH AVE N SUITE 200
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5447
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Country | US
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Telephone | 843-839-5262
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Fax | 843-839-5264
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Provider Business Mailing Address
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Address Line | 1211 44TH AVE N SUITE 200
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5447
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Country | US
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Telephone | 843-839-5262
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. ALAN HERNDON LEVY
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Credential |
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Telephone | 843-839-5262
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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 | 3152
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License Number State | SC
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