Provider Demographics
NPI:1598876138
Name:MCKINNEY, DONALD ROSS (DC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ROSS
Last Name:MCKINNEY
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:LIFEWORKS STUDIOS LLC
Mailing Address - Street 2:PO BOX 26326
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29616-1326
Mailing Address - Country:US
Mailing Address - Phone:864-918-0043
Mailing Address - Fax:864-244-4151
Practice Address - Street 1:4109 E NORTH ST
Practice Address - Street 2:SUITE 100-B
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6209
Practice Address - Country:US
Practice Address - Phone:864-918-0043
Practice Address - Fax:864-244-4151
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor