MEDICARE: ART OF HEALTH 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
1	111N00000X	Chiropractor	3907	SC

General Provider Information

NPI Number	:	1417365289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ART OF HEALTH LLC

Provider Business Mailing Address
First Line	:	3000 HARBOUR LAKE DR APT 13A
Second Line	:
City	:	GOOSE CREEK
State	:	SC
Zip	:	29445-4913
Country	:	US
Telephone Number	:	989-413-3653
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 HARBOUR LAKE DR APT 13A
Second Line	:
City	:	GOOSE CREEK
State	:	SC
Zip	:	29445-4913
Country	:	US
Telephone Number	:	989-413-3653
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL MEMBER
Name	:	DR. ARIEL ELIZABETH BLACKBURN
Credential	:	D.C.
Telephone Number	:	989-413-3653

Provider Enumeration Date	:	07/24/2014
Last Update Date	:	09/23/2014

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Directions to “ART OF HEALTH LLC ” Practice Location

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