MEDICARE: TERESA MARIE NEALEY DC

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
1	111N00000X	Chiropractor	4900	SC

General Provider Information

NPI Number	:	1255332045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA MARIE NEALEY DC

Provider Business Mailing Address
First Line	:	2409 WATSON DR
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-4349
Country	:	US
Telephone Number	:	715-271-2330
Fax Number	:

Provider Business Practice Location Address
First Line	:	1259 38TH AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-1313
Country	:	US
Telephone Number	:	843-605-1600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	02/23/2025

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