Provider Demographics
NPI:1275378978
Name:CAROLINA LIFE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CAROLINA LIFE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:PERKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-779-5433
Mailing Address - Street 1:203 VALHALLA LN
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-6306
Mailing Address - Country:US
Mailing Address - Phone:843-822-8837
Mailing Address - Fax:
Practice Address - Street 1:2700 WOODRUFF RD STE L
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3642
Practice Address - Country:US
Practice Address - Phone:864-779-5433
Practice Address - Fax:864-779-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty