Provider Demographics
NPI:1982092508
Name:ABSOLUTE WELLNESS CENTER
Entity type:Organization
Organization Name:ABSOLUTE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-416-8218
Mailing Address - Street 1:966 HOUSTON NORTHCUTT BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3487
Mailing Address - Country:US
Mailing Address - Phone:843-416-8218
Mailing Address - Fax:
Practice Address - Street 1:966 HOUSTON NORTHCUTT BLVD STE F
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3487
Practice Address - Country:US
Practice Address - Phone:843-416-8218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty