MEDICARE: SYNERGY WELLNESS SOLUTIONS

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	2781	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	:	1679594949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY WELLNESS SOLUTIONS

Provider Business Mailing Address
First Line	:	1078 BEXLEY ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-4934
Country	:	US
Telephone Number	:	843-737-3589
Fax Number	:	843-875-3817

Provider Business Practice Location Address
First Line	:	4491 SUMMEY ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-3214
Country	:	US
Telephone Number	:	843-727-3589
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUSTIN JAMES
Credential	:	DC
Telephone Number	:	843-737-3589

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	04/13/2020

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Directions to “SYNERGY WELLNESS SOLUTIONS ” Practice Location

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