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General NPI Number Information
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NPI Number | 1962807560
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE CHIROPRACTIC INC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 1615 WADE HAMPTON BLVD SUITE B
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City | GREENVILLE
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State | SC
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Zip | 29609-5062
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Country | US
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Telephone | 864-292-9853
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 WADE HAMPTON BLVD SUITE B
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City | GREENVILLE
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State | SC
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Zip | 29609-5062
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Country | US
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Telephone | 864-292-9853
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA ROCHELLE KLOPP-SILVA
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Credential | DC
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Telephone | 864-292-9853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2548
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License Number State | SC
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