Provider Demographics
NPI:1134695711
Name:PATRIOTS POINT CHIROPRACTIC
Entity Type:Organization
Organization Name:PATRIOTS POINT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUERBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-856-0351
Mailing Address - Street 1:907 HOUSTON NORTHCUTT BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3448
Mailing Address - Country:US
Mailing Address - Phone:843-856-0351
Mailing Address - Fax:843-856-0354
Practice Address - Street 1:907 HOUSTON NORTHCUTT BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3448
Practice Address - Country:US
Practice Address - Phone:843-856-0351
Practice Address - Fax:843-856-0354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty