Provider Demographics
NPI:1770507204
Name:WORLEY, DONALD B (RT, BA, DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:B
Last Name:WORLEY
Suffix:
Gender:M
Credentials:RT, BA, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 385
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-0385
Mailing Address - Country:US
Mailing Address - Phone:864-833-1295
Mailing Address - Fax:864-833-3439
Practice Address - Street 1:28072 HIGHWAY 76 E
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-5325
Practice Address - Country:US
Practice Address - Phone:864-833-1295
Practice Address - Fax:864-833-3439
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1454Medicaid
SC350029873OtherRAILROAD MEDICARE
SC350029873OtherRAILROAD MEDICARE
SCCH1454Medicaid