Provider Demographics
NPI:1891948535
Name:DR. CAROLYN HUNTER PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DR. CAROLYN HUNTER PROFESSIONAL CORPORATION
Other - Org Name:DBA CHARLESTON NECK AND BACK CENTER/PALMETTO PAIN RELIEF CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-670-8703
Mailing Address - Street 1:2102 OTRANTO BLVD.
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406
Mailing Address - Country:US
Mailing Address - Phone:843-569-2225
Mailing Address - Fax:843-863-1830
Practice Address - Street 1:2102 OTRANTO BLVD.
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-569-2225
Practice Address - Fax:843-863-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2991111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8924OtherMEDICARE PTAN
SCCH2991Medicaid
SC8924OtherMEDICARE PTAN
SCCH2991Medicaid