Provider Demographics
NPI:1306809363
Name:MIGNANO FAMILY CHIROPRACTIC CENTER LLC
Entity type:Organization
Organization Name:MIGNANO FAMILY CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER, OWNER, AO
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGNANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-762-2386
Mailing Address - Street 1:914 FOLLY RD STE D
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3900
Mailing Address - Country:US
Mailing Address - Phone:843-762-2386
Mailing Address - Fax:843-795-9871
Practice Address - Street 1:914 FOLLY RD STE D
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3900
Practice Address - Country:US
Practice Address - Phone:843-762-2386
Practice Address - Fax:843-795-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH481Medicaid
SC8209Medicare ID - Type Unspecified
SCGCH481Medicaid
SCU90593Medicare UPIN