Provider Demographics
NPI:1609372192
Name:E320 CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:E320 CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LISOWE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-367-6766
Mailing Address - Street 1:2500 N MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3277
Mailing Address - Country:US
Mailing Address - Phone:864-367-6766
Mailing Address - Fax:
Practice Address - Street 1:2500 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3277
Practice Address - Country:US
Practice Address - Phone:864-367-6766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty