Provider Demographics
NPI:1194111534
Name:GREATER FAMILY HEALTH CENTER, LLC
Entity type:Organization
Organization Name:GREATER FAMILY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-964-4110
Mailing Address - Street 1:625 CROWN POINTE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5191
Mailing Address - Country:US
Mailing Address - Phone:803-619-1433
Mailing Address - Fax:844-685-9246
Practice Address - Street 1:625 CROWN POINTE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5191
Practice Address - Country:US
Practice Address - Phone:803-619-1433
Practice Address - Fax:844-685-9246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty