Provider Demographics
NPI:1033238142
Name:SOUTH HILLS CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:SOUTH HILLS CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-342-8800
Mailing Address - Street 1:1105 BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-1307
Mailing Address - Country:US
Mailing Address - Phone:304-342-8800
Mailing Address - Fax:304-342-8069
Practice Address - Street 1:1105 BRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-1307
Practice Address - Country:US
Practice Address - Phone:304-342-8800
Practice Address - Fax:304-342-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty