MEDICARE: PC MARTIN 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
1	111N00000X	Chiropractor	2851	SC
2	111N00000X	Chiropractor	2253	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295713519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PC MARTIN CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	400 HWY 17 N
Second Line	:
City	:	SURFSIDE BEACH
State	:	SC
Zip	:	29575-6029
Country	:	US
Telephone Number	:	843-238-5900
Fax Number	:	843-238-5910

Provider Business Practice Location Address
First Line	:	400 HWY 17 N
Second Line	:
City	:	SURFSIDE BEACH
State	:	SC
Zip	:	29575-6029
Country	:	US
Telephone Number	:	843-238-5900
Fax Number	:	843-238-5910

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CAROLE A MARTIN
Credential	:	DC
Telephone Number	:	843-238-5900

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	12/19/2014

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