Provider Demographics
NPI:1952324501
Name:CONNER, DARIN SHANE (DC)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:SHANE
Last Name:CONNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 OLD CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-9406
Mailing Address - Country:US
Mailing Address - Phone:803-359-2273
Mailing Address - Fax:803-359-3497
Practice Address - Street 1:716 OLD CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9406
Practice Address - Country:US
Practice Address - Phone:803-359-2273
Practice Address - Fax:803-359-3497
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor