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General NPI Number Information
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NPI Number | 1710291893
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Entity Type | Organization
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Legal Business Name | COLUMBIA FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 08/02/2010
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 224 ONEIL CT STE 21
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City | COLUMBIA
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State | SC
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Zip | 29223-7649
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Country | US
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Telephone | 803-788-8831
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Fax |
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Provider Business Mailing Address
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Address Line | 224 ONEIL CT STE 12
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City | COLUMBIA
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State | SC
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Zip | 29223-7649
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Country | US
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Telephone | 814-397-6516
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. THOMAS JAY STETSON
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Credential | D.C.
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Telephone | 803-995-9193
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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 | 3554
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License Number State | SC
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