Provider Demographics
NPI:1073201687
Name:AWAKENING LIFE CHIROPRACTIC UPPER CERVICAL HEALTH CENTER PC
Entity Type:Organization
Organization Name:AWAKENING LIFE CHIROPRACTIC UPPER CERVICAL HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-510-4200
Mailing Address - Street 1:300 GOLIGHTLY ST
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-8474
Mailing Address - Country:US
Mailing Address - Phone:864-510-4190
Mailing Address - Fax:
Practice Address - Street 1:420 THE PKWY STE I-B
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-5204
Practice Address - Country:US
Practice Address - Phone:864-416-4485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty