Provider Demographics
NPI:1609808609
Name:ALTERNATIVE HEALTH CLINIC
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIN
Authorized Official - Middle Name:LI
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-692-9243
Mailing Address - Street 1:PO BOX 50727
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-0013
Mailing Address - Country:US
Mailing Address - Phone:843-692-9243
Mailing Address - Fax:843-692-9245
Practice Address - Street 1:4810 N KINGS HWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-2504
Practice Address - Country:US
Practice Address - Phone:843-692-9243
Practice Address - Fax:843-692-9245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1602171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7492Medicare ID - Type UnspecifiedCHIROPRACTIC