Provider Demographics
NPI:1780635763
Name:PARTRIDGE, ANDREW C (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:C
Last Name:PARTRIDGE
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 1:1000 JOHNNIE DODDS BLVD
Mailing Address - Street 2:SUITE 105 B
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3135
Mailing Address - Country:US
Mailing Address - Phone:843-388-8813
Mailing Address - Fax:843-216-8870
Practice Address - Street 1:1000 JOHNNIE DODDS BLVD
Practice Address - Street 2:SUITE 105 B
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3135
Practice Address - Country:US
Practice Address - Phone:843-388-8813
Practice Address - Fax:843-216-8870
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU98140Medicare UPIN