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General NPI Number Information
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NPI Number | 1346480993
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Entity Type | Individual
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Provider Name | ROY FUNDERBURKE BURCH III D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 2234 W PALMETTO ST SUITE C
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City | FLORENCE
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State | SC
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Zip | 29501-4047
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Country | US
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Telephone | 843-669-5255
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Fax | 843-669-5355
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Provider Business Mailing Address
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Address Line | PO BOX 5537
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City | FLORENCE
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State | SC
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Zip | 29502-5537
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Country | US
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Telephone | 843-669-5255
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Fax | 843-669-5355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3426
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License Number State | SC
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