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General NPI Number Information
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NPI Number | 1689326365
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Entity Type | Individual
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Provider Name | MACKENZIE PAIGE BUCK DC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 1907 VARNER ST STE C2
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8104
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Country | US
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Telephone | 843-419-6955
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Fax |
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Provider Business Mailing Address
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Address Line | 820 CARTWRIGHT DR
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City | CHARLESTON
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State | SC
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Zip | 29414-5128
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Country | US
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Telephone | 304-216-9399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4760
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License Number State | SC
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