Provider Demographics
NPI:1417291709
Name:MCGILL, MICHELLE L (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:L
Last Name:MCGILL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SILVERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:SAINT MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-7609
Mailing Address - Country:US
Mailing Address - Phone:843-312-9133
Mailing Address - Fax:
Practice Address - Street 1:135 SILVERBERRY LN
Practice Address - Street 2:
Practice Address - City:SAINT MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-7609
Practice Address - Country:US
Practice Address - Phone:843-312-9133
Practice Address - Fax:800-915-0394
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011670X111NP0017X, 111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician