| NPI | 1609431030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK DWYER SCOTT Owner 843-742-7922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |