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General NPI Number Information
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NPI Number | 1538414735
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Entity Type | Organization
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Legal Business Name | CHANDLER CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 3119 SUNSET BLVD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-3425
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Country | US
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Telephone | 803-796-0855
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Fax | 803-796-0028
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Provider Business Mailing Address
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Address Line | 3119 SUNSET BLVD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-3425
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Country | US
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Telephone | 803-796-0855
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Fax | 803-796-0028
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID W CHANDLER
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Credential | DC
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Telephone | 803-796-0855
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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 | 2068
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License Number State | SC
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