Provider Demographics
NPI:1952822140
Name:PAGE, NATHAN HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:HENRY
Last Name:PAGE
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:PO BOX 632
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:SC
Mailing Address - Zip Code:29477-0632
Mailing Address - Country:US
Mailing Address - Phone:843-970-3200
Mailing Address - Fax:843-353-2406
Practice Address - Street 1:5502 MEMORIAL BLVD UNIT 3
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:SC
Practice Address - Zip Code:29477-2286
Practice Address - Country:US
Practice Address - Phone:843-970-3200
Practice Address - Fax:843-353-2406
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor