Provider Demographics
NPI:1710025606
Name:MEDICAL-REHAB & BOOK CHIROPRACTIC
Entity Type:Organization
Organization Name:MEDICAL-REHAB & BOOK CHIROPRACTIC
Other - Org Name:BOOK CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOOK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-661-0394
Mailing Address - Street 1:509 N HWY. 52
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461
Mailing Address - Country:US
Mailing Address - Phone:843-899-7777
Mailing Address - Fax:843-899-7781
Practice Address - Street 1:509 N HWY. 52
Practice Address - Street 2:SUITE B
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461
Practice Address - Country:US
Practice Address - Phone:843-899-7777
Practice Address - Fax:843-899-7781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2956OtherSC LICENSE
KY85000149Medicaid
KY85000149Medicaid
SC2956OtherSC LICENSE