Provider Demographics
NPI:1316166853
Name:CALHOUN FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:CALHOUN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-653-3928
Mailing Address - Street 1:1353 TIGER BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-2632
Mailing Address - Country:US
Mailing Address - Phone:864-653-3928
Mailing Address - Fax:864-653-4949
Practice Address - Street 1:1353 TIGER BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2632
Practice Address - Country:US
Practice Address - Phone:864-653-3928
Practice Address - Fax:864-653-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2766111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2766Medicaid
SCU93685Medicare UPIN