Provider Demographics
NPI:1376888586
Name:BARNWELL CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BARNWELL CHIROPRACTIC LLC
Other - Org Name:MARTIN L. SHEALY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:LAYNE
Authorized Official - Last Name:SHEALY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-259-9412
Mailing Address - Street 1:76 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-1500
Mailing Address - Country:US
Mailing Address - Phone:803-259-9412
Mailing Address - Fax:803-259-0559
Practice Address - Street 1:76 IRVING ST
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-1500
Practice Address - Country:US
Practice Address - Phone:803-259-9412
Practice Address - Fax:803-259-0559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARNWELL CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU720810281Medicare UPIN