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NPI 1467664516

NPI 1467664516 : HILLCREST CHIROPRACTIC ASSOCIATES P.A. : SIMPSONVILLE, SC

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General NPI Number Information
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    NPI Number           |    1467664516
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    Entity Type          |    Organization 
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    Legal Business Name  |    HILLCREST CHIROPRACTIC ASSOCIATES P.A. 
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Dates
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    Enumeration Date     |    05/03/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    110 S. MAIN STREET 
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    City                 |    SIMPSONVILLE
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    State                |    SC
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    Zip                  |    29681-2628
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    Country              |    US
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    Telephone            |    864-963-4601
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    110 S. MAIN STREET 
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    City                 |    SIMPSONVILLE
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    State                |    SC
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    Zip                  |    29681-2628
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    Country              |    US
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    Telephone            |    864-963-4601
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. THOMAS WARING JOHNSTON 
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    Credential           |    D.C.
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    Telephone            |    864-963-4601
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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       |    1970
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    License Number State |    SC
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