MEDICARE: CHILTON CHIROPRACTIC

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	2467	SC

General Provider Information

NPI Number	:	1588830137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILTON CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1720 HIGHWAY 501
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-9750
Country	:	US
Telephone Number	:	843-946-6325
Fax Number	:	843-626-6776

Provider Business Practice Location Address
First Line	:	1720 HIGHWAY 501
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-9750
Country	:	US
Telephone Number	:	843-946-6325
Fax Number	:	843-626-6776

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. RUBERT GARLAND CHILTON
Credential	:	D.C.
Telephone Number	:	843-946-6325

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	09/23/2008

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Directions to “CHILTON CHIROPRACTIC ” Practice Location

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