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General NPI Number Information
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NPI Number | 1831889500
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Entity Type | Organization
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Legal Business Name | SUMMIT CHIROPRACTIC
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 1990 AUGUSTA ST STE 202
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City | GREENVILLE
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State | SC
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Zip | 29605-6510
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Country | US
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Telephone | 704-756-1813
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Fax |
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Provider Business Mailing Address
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Address Line | 223 WILDER DR
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City | SPARTANBURG
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State | SC
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Zip | 29301-3613
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Country | US
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Telephone | 704-756-1813
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LACEY GARCIA
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Credential | D.C.
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Telephone | 704-756-1813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number |
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License Number State |
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