Provider Demographics
NPI:1912181256
Name:ABNER CREEK FAMILY AND SPORTS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ABNER CREEK FAMILY AND SPORTS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:C
Authorized Official - Last Name:KEELS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-801-3230
Mailing Address - Street 1:1110 BERRY SHOALS ROAD
Mailing Address - Street 2:ABNER CREEK FAMILY & SPORTS CHIROPRACTIC
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651
Mailing Address - Country:US
Mailing Address - Phone:864-801-3230
Mailing Address - Fax:864-801-3223
Practice Address - Street 1:1110 BERRY SHOALS ROAD
Practice Address - Street 2:ABNER CREEK FAMILY & SPORTS CHIROPRACTIC
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651
Practice Address - Country:US
Practice Address - Phone:864-801-3230
Practice Address - Fax:864-801-3223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3000111N00000X
SC300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH300Medicaid
SCV06841Medicare PIN