WACCAMAW FAMILY CHIROPRACTIC, P.C. (NPI# 1043617202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043617202 |
| Entity Type | Organization |
| Organization Name | WACCAMAW FAMILY CHIROPRACTIC, P.C. |
| Other Organization Name | TRIUNE OF LIFE CHIROPRACTIC, P.C. |
| Practice Address |
1153 N Fraser St Georgetown SC 29440-2851 |
| Practice Telephone | 8435457201 |
| Practice Fax Number | 8435457202 |
| Mailing Telephone | 8435457201 |
| Mailing Fax Number | 8435457202 |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |
| Authorized Official Name | DR. MATTHEW R CULLUM (PRESIDENT) |
| Authorized Official Telephone | 8032408766 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3457 | SC | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Triune of Life Chiropractic, P.C. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215162136 | Waccamaw Family Chiropractic, P.C. | Chiropractor | 11945 Grandhaven Dr, Suite F, Murrells Inlet, SC 29576-8091 | 2009-05-20 |
| Street Address |
1153 N FRASER ST |
| City | GEORGETOWN |
| State | SC |
| Zip Code | 29440-2851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558754812 | Lyle Barker | Chiropractor | 1153 N Fraser St, Georgetown, SC 29440-2851 | 2015-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003288788 | Bartou Wilson | Pharmacist | 513 Rosemont St, Georgetown, SC 29440 | 2015-10-21 |
| 1538557780 | Sc Pain and Spine Specialist | Pain Medicine | 230 S Fraser Street, Georgetown, SC 29440 | 2014-12-22 |
| 1326393745 | Rose Carpenzano | Social Worker | 525 Lafayette Circle, Waccamaw Center for Mental Health, Georgetown, SC 29440 | 2012-07-23 |
| 1942575451 | Surgical Specialists of Waccamaw, LLC | Surgery | 4367 Riverwood Drive, Suite 130, Murrells Inlet, SC 29440 | 2012-03-16 |
| 1619296654 | Lisa Marie Holmes | Durable Medical Equipment & Medical Supplies | 1263 N. Frazer St., Georgetown, SC 29440 | 2010-05-28 |
| 1104156892 | Georgetown Anesthesia Consultants, PC | Anesthesiology | 606 Blackriver Road, Georgetown, SC 29440 | 2010-01-04 |
| 1306018999 | Heather Denise Sharpe | Pharmacist | 810 Elizabeth Street, Georgetown, SC 29440 | 2008-03-24 |
| 1083882054 | Advanced Chiropractic Center | Chiropractor | 705 North Fraser Street, Advanced Chiropractic Center, Georgetown, SC 29440 | 2008-02-13 |
| 1295922284 | Georgetown Memorial Hospital | Clinic/Center | 2361 North Frasier Street, Georgetown, SC 29440 | 2007-10-03 |
| 1114110863 | Thomas Clifford Rowland Jr. | Obstetrics & Gynecology | 74 Swan Point Trail, Georgetown, SC 29440 | 2007-08-24 |
| Find all providers in zip 29440 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627286 | Kirsten Rene Parker | Chiropractor | 750 County Road 234 Bldg 1, Georgetown, TX 78633-4426 | 2020-10-20 |
| 1053973644 | Georgetown Chiropractic Center | Chiropractor | 1304 Paris Pike, Georgetown, KY 40324-9704 | 2019-07-03 |
| 1376001651 | Shelby Danielle Phillips | Chiropractor | 1520 Leander Rd Ste 103, Georgetown, TX 78628-8842 | 2019-03-06 |
| 1366918252 | Sammie Mees | Chiropractor | 1103 Williams Dr Ste 101, Georgetown, TX 78628-4109 | 2018-10-17 |
| 1043706344 | Acc-georgetown LLC | Chiropractor | 3007 Dawn Dr Ste 101, Georgetown, TX 78628-2864 | 2018-07-10 |
| 1124526223 | Legacy Chiropractic Inc | Chiropractor | 205 Champion Way Ste 9, Georgetown, KY 40324-8862 | 2018-01-24 |
| 1255845830 | Chelsea Hartinger | Chiropractor | 105 Windsor Path Ste 4, Georgetown, KY 40324-9819 | 2017-11-19 |
| 1457877342 | Credence Chiropractic LLC | Chiropractor | 1103 Rivery Dr Ste 120, Georgetown, TX 78628-3056 | 2017-08-22 |
| 1134519127 | Miranda Wall | Chiropractor | 100 River Hills Dr Ste 102, Georgetown, TX 78628-3682 | 2015-01-28 |
| 1851798292 | Clark Mandel | Chiropractor | 108 Osbourne Way Ste 6, Georgetown, KY 40324-9693 | 2014-12-01 |
| Find all providers in GEORGETOWN | ||||
| City | GEORGETOWN |
| Zip Code | 29440 |
Please comment or provide details below to improve the information on WACCAMAW FAMILY CHIROPRACTIC, P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.