Provider Demographics
NPI:1518317817
Name:HUNTER SPINE AND PAIN CENTER
Entity Type:Organization
Organization Name:HUNTER SPINE AND PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-410-7201
Mailing Address - Street 1:2409 MALL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-6506
Mailing Address - Country:US
Mailing Address - Phone:843-401-7201
Mailing Address - Fax:843-402-7204
Practice Address - Street 1:2409 MALL DR
Practice Address - Street 2:SUITE C
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6506
Practice Address - Country:US
Practice Address - Phone:843-401-7201
Practice Address - Fax:843-402-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty