Provider Demographics
NPI:1669832879
Name:MESSINA, SAMANTHA (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:MESSINA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 SUNSET BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7332
Mailing Address - Country:US
Mailing Address - Phone:803-609-8503
Mailing Address - Fax:803-832-1793
Practice Address - Street 1:5140 SUNSET BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7332
Practice Address - Country:US
Practice Address - Phone:803-609-8503
Practice Address - Fax:803-832-1793
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor