Provider Demographics
NPI:1881099760
Name:WARREN, GEORGE ANDREW (DC, BS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ANDREW
Last Name:WARREN
Suffix:
Gender:M
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11489 SC HIGHWAY 121
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-9137
Mailing Address - Country:US
Mailing Address - Phone:803-276-8833
Mailing Address - Fax:803-276-8837
Practice Address - Street 1:11489 SC HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-9137
Practice Address - Country:US
Practice Address - Phone:803-276-8833
Practice Address - Fax:803-276-8837
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3991111NI0013X, 111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NR0400XChiropractic ProvidersChiropractorRehabilitation