MEDICARE: TM&M, 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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1912618497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TM&M, LLC

Provider Business Mailing Address
First Line	:	610 JANCUS ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-8241
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	907 HOUSTON NORTHCUTT BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3448
Country	:	US
Telephone Number	:	843-856-0351
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RYAN DUKE
Credential	:	DC
Telephone Number	:	843-534-0479

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	12/06/2022

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