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General NPI Number Information
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NPI Number | 1588338016
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Entity Type | Organization
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Legal Business Name | MISSION CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 08/07/2021
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Last Update Date | 08/07/2021
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Provider Practice Location Address
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Address Line | 2106 WOODRUFF RD STE A
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City | GREENVILLE
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State | SC
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Zip | 29607-6944
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Country | US
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Telephone | 864-565-9920
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Fax | 864-565-9921
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Provider Business Mailing Address
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Address Line | 2106 WOODRUFF RD STE A
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City | GREENVILLE
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State | SC
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Zip | 29607-6944
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Country | US
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Telephone | 864-565-9920
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Fax | 864-565-9921
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. HALEY OWENS JAMES
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Credential | DO
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Telephone | 864-640-0541
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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 |
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License Number State |
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