Provider Demographics
NPI:1104021229
Name:PAUL W FRIEDMAN DC LLC
Entity Type:Organization
Organization Name:PAUL W FRIEDMAN DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-225-2588
Mailing Address - Street 1:1124 SAM RITTENBERG BLVD
Mailing Address - Street 2:SUITE #4
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3362
Mailing Address - Country:US
Mailing Address - Phone:843-225-2588
Mailing Address - Fax:843-225-2599
Practice Address - Street 1:1124 SAM RITTENBERG BLVD
Practice Address - Street 2:SUITE #4
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-3362
Practice Address - Country:US
Practice Address - Phone:843-225-2588
Practice Address - Fax:843-225-2599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty