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General NPI Number Information
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NPI Number | 1518593334
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Entity Type | Organization
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Legal Business Name | WALTON FAMILY CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 126 WARLEY ST STE A
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City | FLORENCE
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State | SC
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Zip | 29501-4443
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Country | US
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Telephone | 843-508-8181
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Fax | 806-626-1474
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Provider Business Mailing Address
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Address Line | 126 WARLEY ST STE A
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City | FLORENCE
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State | SC
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Zip | 29501-4443
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Country | US
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Telephone | 843-508-8181
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Fax | 806-626-1474
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Authorized Official
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Title or Position | OWNER, CHIROPRACTIC PHYSICIAN
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Name | DR. SAMANTHA JO WALTON
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Credential | DC
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Telephone | 843-508-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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Taxonomy #4
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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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