Provider Demographics
NPI:1922165380
Name:PALMETTO CLINIC OF CHIROPRACTIC
Entity Type:Organization
Organization Name:PALMETTO CLINIC OF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:HELMS
Authorized Official - Last Name:HRYSIKOS SINK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-244-4123
Mailing Address - Street 1:4200 E. NORTH ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615
Mailing Address - Country:US
Mailing Address - Phone:864-244-4123
Mailing Address - Fax:864-244-6879
Practice Address - Street 1:4200 E. NORTH ST UNIT 6
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-244-4123
Practice Address - Fax:864-244-6879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC=========OtherTAX ID NUMBER