Provider Demographics
NPI:1982955936
Name:TERRY, NATHAN ROBERT I (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ROBERT
Last Name:TERRY
Suffix:I
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 1:4252 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7990
Mailing Address - Country:US
Mailing Address - Phone:618-292-4832
Mailing Address - Fax:803-548-6222
Practice Address - Street 1:6277 CAROLINA COMMONS DR STE 500
Practice Address - Street 2:
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-6006
Practice Address - Country:US
Practice Address - Phone:803-548-6200
Practice Address - Fax:803-548-6222
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-29
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3766111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic