Provider Demographics
NPI:1558555474
Name:GARRISON PAIN RELIEF CENTER OF CHARLESTON, LLC
Entity Type:Organization
Organization Name:GARRISON PAIN RELIEF CENTER OF CHARLESTON, LLC
Other - Org Name:PALMETTO PAIN RELIEF CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-576-2872
Mailing Address - Street 1:5401 NETHERBY LANE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7363
Mailing Address - Country:US
Mailing Address - Phone:843-576-2872
Mailing Address - Fax:
Practice Address - Street 1:5401 NETHERBY LANE
Practice Address - Street 2:SUITE 402
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7363
Practice Address - Country:US
Practice Address - Phone:843-576-2872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2991111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty