Provider Demographics
NPI:1528241031
Name:ALIGNLIFE OF SUMMERVILLE LLC
Entity type:Organization
Organization Name:ALIGNLIFE OF SUMMERVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:MERCANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-376-5858
Mailing Address - Street 1:1115 CENTRAL AVE
Mailing Address - Street 2:C
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-3018
Mailing Address - Country:US
Mailing Address - Phone:843-376-5858
Mailing Address - Fax:843-376-5858
Practice Address - Street 1:1115 CENTRAL AVE
Practice Address - Street 2:C
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-3018
Practice Address - Country:US
Practice Address - Phone:843-376-5858
Practice Address - Fax:843-376-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1114092343OtherPERSONAL NPI
SC1114092343OtherPERSONAL NPI