Provider Demographics
NPI:1356341952
Name:WORKMAN, BRIAN (DC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:WORKMAN
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 1:149 E BAY ST
Mailing Address - Street 2:STE. 100
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-2104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:149 E BAY ST
Practice Address - Street 2:STE. 100
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-2104
Practice Address - Country:US
Practice Address - Phone:843-722-7074
Practice Address - Fax:843-722-9749
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2677Medicaid