MEDICARE: CAROLINA WELLNESS AND REHABILITATION CENTER

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	3406	SC

General Provider Information

NPI Number	:	1619245750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA WELLNESS AND REHABILITATION CENTER

Provider Business Mailing Address
First Line	:	1211 48TH AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5424
Country	:	US
Telephone Number	:	843-449-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 48TH AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5424
Country	:	US
Telephone Number	:	843-449-1000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/SECRETARY
Name	:	DR. JONATHAN CRAIG STRICKALND
Credential	:	D.C.
Telephone Number	:	843-449-1000

Provider Enumeration Date	:	12/04/2011
Last Update Date	:	12/04/2011

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