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NPI Code Detail

MEDICARE: LIFE CHIROPRACTIC CLINIC

MEDICARE: LIFE CHIROPRACTIC CLINIC
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
1111N00000XChiropractor2935SC

General Provider Information

NPI Number : 1437322245
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE CHIROPRACTIC CLINIC
Provider Business Mailing Address
First Line : 1272 WOODRUFF RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-5754
Country : US
Telephone Number : 864-288-2136
Fax Number : 864-288-6818
Provider Business Practice Location Address
First Line : 1272 WOODRUFF RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-5754
Country : US
Telephone Number : 864-288-2136
Fax Number : 864-288-6818
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. YVETTE ERICA EDWARDS
Credential : DC
Telephone Number : 864-288-2136
Provider Enumeration Date : 04/12/2008
Last Update Date : 04/12/2008

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Directions to “LIFE CHIROPRACTIC CLINIC ” Practice Location

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