Provider Demographics
NPI:1437930708
Name:LIMA, CHARLES HAYDEN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HAYDEN
Last Name:LIMA
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 1:7565 RIVERS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4633
Mailing Address - Country:US
Mailing Address - Phone:843-764-1995
Mailing Address - Fax:
Practice Address - Street 1:255 N HIGHWAY 52 STE 4
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3927
Practice Address - Country:US
Practice Address - Phone:843-761-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor