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NPI Code Detail

MEDICARE: ODYSSEY CHIROPRACTIC & MASSAGE THERAPY, LLC

MEDICARE: ODYSSEY CHIROPRACTIC & MASSAGE THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor1168SC

General Provider Information

NPI Number : 1063462802
Entity Type Code : Organization
Provider Name (Legal Business Name) : ODYSSEY CHIROPRACTIC & MASSAGE THERAPY, LLC
Provider Business Mailing Address
First Line : 413 FARRS BRIDGE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29617-1858
Country : US
Telephone Number : 864-246-0803
Fax Number : 864-246-0555
Provider Business Practice Location Address
First Line : 413 FARRS BRIDGE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29617-1858
Country : US
Telephone Number : 864-246-0803
Fax Number : 864-246-0555
Authorized Official
Title or Position : CO-OWNER, CEO
Name : KATHERINE M HAYNIE
Credential : DC
Telephone Number : 864-246-0803
Provider Enumeration Date : 05/11/2006
Last Update Date : 08/22/2020

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Directions to “ODYSSEY CHIROPRACTIC & MASSAGE THERAPY, LLC ” Practice Location

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