Provider Demographics
NPI:1376607044
Name:EHLICH FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:EHLICH FAMILY CHIROPRACTIC, PC
Other - Org Name:CHIROPRACTICUSA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:B
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:EHLICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-848-3912
Mailing Address - Street 1:606A W POINSETT ST
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1448
Mailing Address - Country:US
Mailing Address - Phone:864-848-3912
Mailing Address - Fax:864-801-1470
Practice Address - Street 1:606A W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1448
Practice Address - Country:US
Practice Address - Phone:864-848-3912
Practice Address - Fax:864-801-1470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1368Medicaid
SCU02298Medicare UPIN
SCCH1368Medicaid