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General NPI Number Information
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NPI Number | 1194672113
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Entity Type | Organization
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Legal Business Name | KB CHIROPRACTIC AND WELLNESS LLC
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 315 CORNFLOWER DR
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City | COLUMBIA
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State | SC
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Zip | 29229-6837
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Country | US
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Telephone | 123-456-7890
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Fax |
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Provider Business Mailing Address
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Address Line | 425 SUMMIT TERRACE CT BLDG 3
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City | COLUMBIA
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State | SC
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Zip | 29229-7056
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBERT BENTON
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Credential |
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Telephone | 123-456-7890
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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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