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General NPI Number Information
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NPI Number | 1841630878
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Entity Type | Organization
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Legal Business Name | TREE OF LIFE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/05/2013
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 110 WILDEWOOD PARK DR SUITE B
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City | COLUMBIA
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State | SC
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Zip | 29223-4301
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Country | US
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Telephone | 803-728-6766
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50621
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City | COLUMBIA
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State | SC
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Zip | 29250-0621
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Country | US
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Telephone | 803-728-6766
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TREMAIN SINGLETON
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Credential | DC
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Telephone | 803-728-6766
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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 | 3746
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License Number State | SC
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