Provider Demographics
NPI:1760651699
Name:EVERETT CHIROPRACTIC LIFE CENTER
Entity Type:Organization
Organization Name:EVERETT CHIROPRACTIC LIFE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-877-7221
Mailing Address - Street 1:810 W WADE HAMPTON BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1325
Mailing Address - Country:US
Mailing Address - Phone:864-877-7221
Mailing Address - Fax:864-877-9295
Practice Address - Street 1:810 W WADE HAMPTON BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1325
Practice Address - Country:US
Practice Address - Phone:864-877-7221
Practice Address - Fax:864-877-9295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty