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General NPI Number Information
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NPI Number | 1235758145
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Entity Type | Organization
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Legal Business Name | GARDNER FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 205 N IRBY ST STE B
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City | FLORENCE
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State | SC
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Zip | 29501-2805
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Country | US
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Telephone | 803-459-2896
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6808
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City | FLORENCE
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State | SC
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Zip | 29502-6808
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Country | US
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Telephone | 843-407-5331
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. CHRISTOPHER BRENT GARDNER
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Credential | DC
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Telephone | 843-407-5331
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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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