Provider Demographics
NPI:1750304325
Name:BASSETT, ERIC PIERCE (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:PIERCE
Last Name:BASSETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 BLACKFISH RD
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-3902
Mailing Address - Country:US
Mailing Address - Phone:843-559-1443
Mailing Address - Fax:843-559-1443
Practice Address - Street 1:608 B HARBOR VIEW ROAD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412
Practice Address - Country:US
Practice Address - Phone:843-795-3456
Practice Address - Fax:843-795-3451
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC2389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA0352-7893Medicare PIN