Provider Demographics
NPI:1679953822
Name:CHIROCHASE LLC
Entity Type:Organization
Organization Name:CHIROCHASE LLC
Other - Org Name:INFINITE HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-574-8881
Mailing Address - Street 1:222 E BLACKSTOCK RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-2627
Mailing Address - Country:US
Mailing Address - Phone:864-574-8881
Mailing Address - Fax:
Practice Address - Street 1:222 E BLACKSTOCK RD
Practice Address - Street 2:SUITE D
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-2627
Practice Address - Country:US
Practice Address - Phone:864-574-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty