Provider Demographics
NPI:1679197446
Name:VERT CHIROPRACTIC
Entity Type:Organization
Organization Name:VERT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-659-8407
Mailing Address - Street 1:14 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2528
Mailing Address - Country:US
Mailing Address - Phone:912-659-8407
Mailing Address - Fax:
Practice Address - Street 1:14 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2528
Practice Address - Country:US
Practice Address - Phone:912-659-8407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty