Provider Demographics
NPI:1093186439
Name:SIMPLY SOUTHERN CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:SIMPLY SOUTHERN CHIROPRACTIC CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND MANAGING OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-501-2360
Mailing Address - Street 1:PO BOX 6534
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29606-6534
Mailing Address - Country:US
Mailing Address - Phone:864-501-2360
Mailing Address - Fax:
Practice Address - Street 1:922 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-1607
Practice Address - Country:US
Practice Address - Phone:864-501-2360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty