| NPI | 1255662748 |
|---|---|
| Doing Business As | HEALTHSOURCE OF WEST ASHLEY |
| Entity Type | Organization |
| Authorized Contact | NATHAN EVAN WIEDRICH Owner 843-225-1236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2010-01-22 |