MEDICARE: DR. KENNETH HORUP D.C.

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	111NS0005X	Sports Physician Chiropractor	2289	SC

General Provider Information

NPI Number	:	1972572634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH HORUP D.C.

Provider Business Mailing Address
First Line	:	4101 MAIN ST
Second Line	:	SUITE A
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-4608
Country	:	US
Telephone Number	:	843-689-2273
Fax Number	:	843-342-3608

Provider Business Practice Location Address
First Line	:	4101 MAIN ST
Second Line	:	SUITE A
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-4608
Country	:	US
Telephone Number	:	843-689-2273
Fax Number	:	843-342-3608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	12/02/2025

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