Provider Demographics
NPI:1750091088
Name:SC LOWCOUNTRY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SC LOWCOUNTRY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:VERCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-314-1936
Mailing Address - Street 1:1112 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-3445
Mailing Address - Country:US
Mailing Address - Phone:386-314-1936
Mailing Address - Fax:843-321-8697
Practice Address - Street 1:2121 BOUNDARY ST STE 205
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6815
Practice Address - Country:US
Practice Address - Phone:843-252-0540
Practice Address - Fax:843-321-8697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty