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General NPI Number Information
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NPI Number | 1932368156
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Entity Type | Organization
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Legal Business Name | WEAVER CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 105 WARLEY ST
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City | FLORENCE
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State | SC
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Zip | 29501-4442
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Country | US
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Telephone | 843-669-1680
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Fax | 843-669-0266
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Provider Business Mailing Address
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Address Line | 105 WARLEY ST
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City | FLORENCE
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State | SC
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Zip | 29501-4442
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Country | US
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Telephone | 843-669-1680
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Fax | 843-669-0266
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. BRADLEY KANE WEAVER
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Credential | DC
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Telephone | 843-669-1680
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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 | 2541
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License Number State | SC
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