Provider Demographics
NPI:1841258910
Name:WILLEY, ROBIN MEREDITH (DC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MEREDITH
Last Name:WILLEY
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 1:3203 HIGHWAY 9 E
Mailing Address - Street 2:SUITE B
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-7825
Mailing Address - Country:US
Mailing Address - Phone:843-390-3244
Mailing Address - Fax:843-390-3245
Practice Address - Street 1:3203 HIGHWAY 9 E
Practice Address - Street 2:SUITE B
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-7825
Practice Address - Country:US
Practice Address - Phone:843-390-3244
Practice Address - Fax:843-390-3245
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH506Medicaid
SCT47090Medicare UPIN
SCGCH506Medicaid