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General NPI Number Information
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NPI Number | 1891059200
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Entity Type | Organization
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Legal Business Name | HOLISTIC CARE OF CHARLESTON
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 354 FOLLY RD SUITE 1
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City | CHARLESTON
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State | SC
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Zip | 29412-2594
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Country | US
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Telephone | 843-795-9333
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Fax | 866-610-1495
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Provider Business Mailing Address
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Address Line | 354 FOLLY RD SUITE 1
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City | CHARLESTON
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State | SC
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Zip | 29412-2594
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Country | US
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Telephone | 843-795-9333
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Fax | 866-610-1495
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE HOWARD GWINNUP
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Credential | D.C.
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Telephone | 843-795-9333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 2144
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License Number State | SC
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