Provider Demographics
NPI:1356633036
Name:RIVERS, MICHAEL PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:RIVERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 EAGLE CREST DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-7721
Mailing Address - Country:US
Mailing Address - Phone:843-337-6041
Mailing Address - Fax:843-280-6289
Practice Address - Street 1:702-5 6TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582
Practice Address - Country:US
Practice Address - Phone:843-249-5433
Practice Address - Fax:843-280-6289
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor