Provider Demographics
NPI:1235879644
Name:PALMETTO NATURAL HEALTH LLC
Entity Type:Organization
Organization Name:PALMETTO NATURAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KESTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-312-2571
Mailing Address - Street 1:117 GRAND PALM LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5860
Mailing Address - Country:US
Mailing Address - Phone:516-312-2571
Mailing Address - Fax:
Practice Address - Street 1:966 HOUSTON NORTHCUTT BLVD STE F
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3487
Practice Address - Country:US
Practice Address - Phone:516-312-2571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty