Provider Demographics
NPI:1285732982
Name:GUEST CHIROPRACTIC
Entity type:Organization
Organization Name:GUEST CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GUEST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-578-3001
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-0309
Mailing Address - Country:US
Mailing Address - Phone:864-850-1441
Mailing Address - Fax:
Practice Address - Street 1:9438 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-9362
Practice Address - Country:US
Practice Address - Phone:864-578-3001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
SC0282Medicare PIN