| NPI | 1215000278 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | MARK SHIRLEY Member 803-772-7626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 2245) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-12-19 |