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NPI Code Detail

MEDICARE: SPINE PAIN CENTER SURFSIDE LLC

MEDICARE: SPINE PAIN CENTER SURFSIDE 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 : 1861094955
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPINE PAIN CENTER SURFSIDE LLC
Provider Business Mailing Address
First Line : 248 COOPER RIVER DR
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-1814
Country : US
Telephone Number : 803-260-7990
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 : 803-260-7990
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JOSEPH CAREW
Credential : DC
Telephone Number : 803-260-7990
Provider Enumeration Date : 11/12/2020
Last Update Date : 11/16/2020

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Directions to “SPINE PAIN CENTER SURFSIDE LLC ” Practice Location

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