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NPI Code Detail

MEDICARE: FIREFLY CHIROPRACTIC LLC

MEDICARE: FIREFLY CHIROPRACTIC 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1720451818
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIREFLY CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 400 HIGHWAY 17 N
Second Line :
City : SURFSIDE BEACH
State : SC
Zip : 29575-6029
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 HIGHWAY 17 N
Second Line :
City : SURFSIDE BEACH
State : SC
Zip : 29575-6029
Country : US
Telephone Number : 843-238-5900
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. MONIQUE LUMMUS
Credential :
Telephone Number : 972-768-6582
Provider Enumeration Date : 11/11/2015
Last Update Date : 11/11/2015

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Directions to “FIREFLY CHIROPRACTIC LLC ” Practice Location

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