Provider Demographics
NPI:1588338016
Name:MISSION CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:MISSION CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:OWENS
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:864-640-0541
Mailing Address - Street 1:2106 WOODRUFF RD STE A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6944
Mailing Address - Country:US
Mailing Address - Phone:864-565-9920
Mailing Address - Fax:864-565-9921
Practice Address - Street 1:2106 WOODRUFF RD STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6944
Practice Address - Country:US
Practice Address - Phone:864-565-9920
Practice Address - Fax:864-565-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty