Provider Demographics
NPI:1134303910
Name:WORLEY CHIROPRACTIC CLINIC PA
Entity Type:Organization
Organization Name:WORLEY CHIROPRACTIC CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-833-1295
Mailing Address - Street 1:28072 HIGHWAY 76 E
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-5325
Mailing Address - Country:US
Mailing Address - Phone:864-833-1295
Mailing Address - Fax:864-833-3439
Practice Address - Street 1:28072 HIGHWAY 76 E
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-5325
Practice Address - Country:US
Practice Address - Phone:864-833-1295
Practice Address - Fax:864-833-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1454Medicaid