Provider Demographics
NPI:1104986124
Name:TURNER CHIROPRACTIC & REHAB LLC
Entity type:Organization
Organization Name:TURNER CHIROPRACTIC & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRUNSON
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-347-9103
Mailing Address - Street 1:210 SINGLETON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9134
Mailing Address - Country:US
Mailing Address - Phone:843-347-9103
Mailing Address - Fax:843-347-9104
Practice Address - Street 1:210 SINGLETON RIDGE RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9134
Practice Address - Country:US
Practice Address - Phone:843-347-9103
Practice Address - Fax:843-347-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2768Medicaid
SCU944450281Medicare UPIN