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General NPI Number Information
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NPI Number | 1194916080
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Entity Type | Organization
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Legal Business Name | ACCIDENT & FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 134 GARNER RD SUITE D
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City | SPARTANBURG
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State | SC
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Zip | 29303-3132
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Country | US
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Telephone | 864-583-8113
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Fax |
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Provider Business Mailing Address
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Address Line | 134 GARNER RD SUITE D
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City | SPARTANBURG
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State | SC
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Zip | 29303-3132
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Country | US
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Telephone | 864-583-8113
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Fax |
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Authorized Official
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Title or Position | VP
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Name | DR. BEVERLY JEAN BOURGEOIS
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Credential | DC,BSN
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Telephone | 864-583-8113
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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 | 808
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License Number State | SC
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