Provider Demographics
NPI:1467521260
Name:HUNT, EDDIE DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:DEAN
Last Name:HUNT
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 1:1113 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2609
Mailing Address - Country:US
Mailing Address - Phone:864-984-5522
Mailing Address - Fax:864-984-2892
Practice Address - Street 1:1113 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2609
Practice Address - Country:US
Practice Address - Phone:864-984-5522
Practice Address - Fax:864-984-2892
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC57-1109891OtherTAX ID #
SCT250880281Medicare UPIN
SCT250880281Medicare ID - Type Unspecified