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NPI Code Detail

MEDICARE: CAROLINA ACTIVE HEALTH CHIROPRACTIC, INC.

MEDICARE: CAROLINA ACTIVE HEALTH CHIROPRACTIC, INC.
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
1111N00000XChiropractor4054SC

General Provider Information

NPI Number : 1215310156
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINA ACTIVE HEALTH CHIROPRACTIC, INC.
Provider Business Mailing Address
First Line : 800 E WASHINGTON ST STE B
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3054
Country : US
Telephone Number : 864-881-2242
Fax Number : 864-881-0361
Provider Business Practice Location Address
First Line : 800 E WASHINGTON ST STE B
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3054
Country : US
Telephone Number : 864-881-2242
Fax Number : 864-881-0361
Authorized Official
Title or Position : CHIROPRACTOR/PRESIDENT
Name : DR. MICHAEL NELSON
Credential : DC, ATC
Telephone Number : 864-881-2242
Provider Enumeration Date : 07/09/2015
Last Update Date : 09/02/2021

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Directions to “CAROLINA ACTIVE HEALTH CHIROPRACTIC, INC. ” Practice Location

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