=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629265186
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A HEALING TOUCH CHIROPRACTIC CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2007
-----------------------------------------------------
Last Update Date | 01/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1531 BLANDING ST
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29201-2931
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-251-2500
-----------------------------------------------------
Fax | 803-251-2900
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7273
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29202-7273
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-251-2500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RANDY LOUIS GOINGS II
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 803-251-2500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 3044
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------