Provider Demographics
NPI:1336275775
Name:BLUNDY, ERIC PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:PAUL
Last Name:BLUNDY
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 1:16 ACCOUNTANTS CIR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-2670
Mailing Address - Country:US
Mailing Address - Phone:864-882-5191
Mailing Address - Fax:864-882-5196
Practice Address - Street 1:16 ACCOUNTANTS CIR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-2670
Practice Address - Country:US
Practice Address - Phone:864-882-5191
Practice Address - Fax:864-882-5196
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02316OtherSTATE HEALTH PLAN
1134153802OtherNPI CORPORATION
1134153802OtherNPI CORPORATION