Relife Pro Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

RELIFE PRO CORPORATION

Doing business as

HealthSource of Indian Land, SC

Practice address

9716 Redstone Dr
Indian Land, SC 29707-5406

Phone

(803) 992-9966

NPI assigned

Dec 17, 2024

Last updated

Dec 17, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Provalenko

Title

Owner

Phone

(803) 992-9966

Specialties & licenses 1

Addresses

Other names 1

• HealthSource of Indian Land, SC Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Todd Ashforth, D.C.

  • Chiropractor
  • Charlotte, NC
  • NPI 1881802882
  NPD
• Robert M Clemons, D.C.

  • Chiropractor
  • Ankeny, IA
  • NPI 1215430798
  NPD
• Keith Brian Duverney

  • Chiropractor
  • New York, NY
  • NPI 1447350970
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1083421564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9716 REDSTONE DR",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297075406",
            "telephone_number": "803-992-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9716 REDSTONE DR",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297075406",
            "telephone_number": "803-992-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIFE PRO CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "PROVALENKO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-992-9966"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Indian Land, SC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dani Jaclyn Rinaldo, PHARMD

• Chiropractor in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.