Provider Demographics
NPI:1659310589
Name:GARRISON PAIN RELIEF CENTER
Entity Type:Organization
Organization Name:GARRISON PAIN RELIEF CENTER
Other - Org Name:
Other - Org Type:
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:843-572-5656
Mailing Address - Street 1:2294 OTRANTO RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9603
Mailing Address - Country:US
Mailing Address - Phone:843-572-5656
Mailing Address - Fax:843-572-6886
Practice Address - Street 1:2294 OTRANTO RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9603
Practice Address - Country:US
Practice Address - Phone:843-572-5656
Practice Address - Fax:843-572-6886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH368Medicaid
SC8537OtherGROUP PIN
SC8537Medicare PIN
SCU53690Medicare UPIN