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General NPI Number Information
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NPI Number | 1447237706
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Entity Type | Individual
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Provider Name | JAMES MATTHEW DURHAM D.C
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 102 ELLIS AVE
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City | ABBEVILLE
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State | SC
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Zip | 29620-2114
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Country | US
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Telephone | 864-366-7777
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Fax | 864-366-7778
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Provider Business Mailing Address
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Address Line | 102 ELLIS AVE
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City | ABBEVILLE
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State | SC
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Zip | 29620-2114
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Country | US
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Telephone | 864-366-7777
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Fax | 864-366-7778
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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 | 1154
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License Number State | SC
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