Provider Demographics
NPI:1780637371
Name:KIRAR, VANCE CHRISTIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:VANCE
Middle Name:CHRISTIAN
Last Name:KIRAR
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 1:5 SOUTH ALLIANCE DR.
Mailing Address - Street 2:STE E
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7174
Mailing Address - Country:US
Mailing Address - Phone:843-572-2224
Mailing Address - Fax:843-572-2274
Practice Address - Street 1:5 SOUTH ALLIANCE DR.
Practice Address - Street 2:STE E
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-7174
Practice Address - Country:US
Practice Address - Phone:843-572-2224
Practice Address - Fax:843-572-2274
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC830397634OtherTAX ID
SC2903OtherLICENSE
SC830397634OtherTAX ID
SCV01374Medicare UPIN