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General NPI Number Information
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NPI Number | 1417389594
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS FAMILY CHIROPRACTIC. LLC
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 1001 PHYSICIANS DR
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City | CHARLESTON
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State | SC
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Zip | 29414-5746
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Country | US
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Telephone | 843-729-0732
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 PHYSICIANS DR
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City | CHARLESTON
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State | SC
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Zip | 29414-5746
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Country | US
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Telephone | 843-729-0732
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/ OWNER
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Name | DR. JACQUELYN BOWMAN-GARRETT
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Credential | D.C.
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Telephone | 843-729-0732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 3836
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License Number State | SC
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