Provider Demographics
NPI:1518238203
Name:PALMETTO CHIROMED, INC.
Entity Type:Organization
Organization Name:PALMETTO CHIROMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:WENNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-662-8000
Mailing Address - Street 1:491 W CHEVES ST STE A
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4407
Mailing Address - Country:US
Mailing Address - Phone:843-662-8000
Mailing Address - Fax:843-664-0994
Practice Address - Street 1:491 W CHEVES ST STE A
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4407
Practice Address - Country:US
Practice Address - Phone:843-662-8000
Practice Address - Fax:843-664-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty