Provider Demographics
NPI:1063683753
Name:AMR ENTERPRISES, LLC
Entity Type:Organization
Organization Name:AMR ENTERPRISES, LLC
Other - Org Name:RYAN FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-875-1626
Mailing Address - Street 1:3525 IRON HORSE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-4331
Mailing Address - Country:US
Mailing Address - Phone:843-875-1626
Mailing Address - Fax:873-913-8376
Practice Address - Street 1:3525 IRON HORSE RD STE 105
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-4331
Practice Address - Country:US
Practice Address - Phone:843-875-1626
Practice Address - Fax:873-913-8376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3111111N00000X
SC3111SC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH3111Medicaid
AA13379049Medicare PIN
SCCH3111Medicaid