Coastal Spine & Wellness Family Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4043 Issued in SC

Legal business name

COASTAL SPINE & WELLNESS FAMILY CHIROPRACTIC

Practice address

3070 N Highway 17
Suite 200
Mt Pleasant, SC 29466-9300

Phone

(843) 352-2180

Fax

(843) 352-2192

NPI assigned

Nov 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Diana Spencer, DC

Title

Owner

Phone

(843) 352-2192

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1134593759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N HIGHWAY 17",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669300",
            "telephone_number": "843-352-2180",
            "fax_number": "843-352-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N HIGHWAY 17",
            "address_2": "SUITE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669300",
            "telephone_number": "843-352-2180",
            "fax_number": "843-352-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SPINE & WELLNESS FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-352-2192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.