Provider Demographics
NPI:1275729717
Name:PISANI, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:PISANI
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 1:9730 DORCHESTER RD UNIT 103
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-9034
Mailing Address - Country:US
Mailing Address - Phone:843-900-6034
Mailing Address - Fax:843-900-6034
Practice Address - Street 1:9730 DORCHESTER RD UNIT 103
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-9034
Practice Address - Country:US
Practice Address - Phone:843-900-6034
Practice Address - Fax:843-900-6034
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor