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General NPI Number Information
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NPI Number | 1669567327
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Entity Type | Organization
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Legal Business Name | SIMPSONVILLE FAMILY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 655 FAIRVIEW RD SUITE J
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-7500
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Country | US
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Telephone | 864-962-8800
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Fax | 864-228-9129
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Provider Business Mailing Address
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Address Line | 655 FAIRVIEW RD SUITE J
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-7500
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Country | US
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Telephone | 864-962-8800
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Fax | 864-228-9129
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN A O'BLENESS
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Credential | D.C.
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Telephone | 864-962-8800
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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 | CH 2503
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 2296
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License Number State | SC
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