Provider Demographics
NPI:1760826838
Name:MIDLANDS CHIROPRACTIC
Entity Type:Organization
Organization Name:MIDLANDS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:A
Authorized Official - Last Name:KZYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-276-0019
Mailing Address - Street 1:3218 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-1638
Mailing Address - Country:US
Mailing Address - Phone:803-276-0019
Mailing Address - Fax:803-276-0019
Practice Address - Street 1:3218 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-1638
Practice Address - Country:US
Practice Address - Phone:803-276-0019
Practice Address - Fax:803-276-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCMEDICAL LICENSESOther3795