Provider Demographics
NPI:1871820662
Name:KIRAR CHIROPRACTIC WELLNESS INC
Entity Type:Organization
Organization Name:KIRAR CHIROPRACTIC WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VANCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIRAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-572-2224
Mailing Address - Street 1:5 S ALLIANCE DR
Mailing Address - Street 2:SUITE 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 1:551 COLLEGE PARK ROAD
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456
Practice Address - Country:US
Practice Address - Phone:843-572-2224
Practice Address - Fax:843-572-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2903111N00000X
SC2906111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty