Provider Demographics
NPI:1033707625
Name:ORR, IAN PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:PATRICK
Last Name:ORR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 RALEIGH RDG APT 306
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-0807
Mailing Address - Country:US
Mailing Address - Phone:704-281-2849
Mailing Address - Fax:
Practice Address - Street 1:1149 STONECREST BLVD STE 106
Practice Address - Street 2:
Practice Address - City:TEGA CAY
Practice Address - State:SC
Practice Address - Zip Code:29708-6604
Practice Address - Country:US
Practice Address - Phone:704-281-2849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor