Provider Demographics
NPI:1033214960
Name:FAMILY CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:FAMILY CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-963-8186
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-0425
Mailing Address - Country:US
Mailing Address - Phone:864-963-8186
Mailing Address - Fax:864-228-2349
Practice Address - Street 1:311 W GEORGIA RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2401
Practice Address - Country:US
Practice Address - Phone:864-963-8186
Practice Address - Fax:864-228-2349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty