Provider Demographics
NPI:1821586637
Name:ROOT CAUSE CHIROPRATIC LLC
Entity Type:Organization
Organization Name:ROOT CAUSE CHIROPRATIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LE ROY
Authorized Official - Last Name:FERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-970-0833
Mailing Address - Street 1:2070 NORTHBROOK BLVD STE B5
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9254
Mailing Address - Country:US
Mailing Address - Phone:843-970-0833
Mailing Address - Fax:
Practice Address - Street 1:2070 NORTHBROOK BLVD STE B5
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9254
Practice Address - Country:US
Practice Address - Phone:843-970-0833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty