| NPI | 1912240383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP R JORDAN Owner/Chiropractor 803-226-0217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 000695) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: SC 17794) |
| 111N00000X Chiropractor (Licence: SC 3663) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-05-03 |