Shady Grove Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2611 Issued in SC

Legal business name

SHADY GROVE CHIROPRACTIC, LLC

Practice address

11134 Broad River Rd Ste C
Irmo, SC 29063-7616

Phone

(803) 781-0031

Fax

(803) 781-0032

NPI assigned

Jun 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jeffery Dale Touchet II, D.C.

Title

President

Phone

(803) 781-0031

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry Eugene Dail Jr., D.C.

  • Chiropractor
  • Columbia, SC
  • NPI 1821151408
  NPD (past)

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1295055283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 184",
            "city": "BALLENTINE",
            "state": "SC",
            "postal_code": "290020184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11134 BROAD RIVER RD STE C",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637616",
            "telephone_number": "803-781-0031",
            "fax_number": "803-781-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY GROVE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "TOUCHET",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-781-0031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamika Glenetta Scott, L.P.C.
• Script RX Inc
• Brooke Scupp
• Thomas Gordon Seastrunk, DO
• Grant L Sebastiano, D.C.
• Shai'S Coaching and Counseling LLC
• Katelyn W Sharpe, PTA
• Timothea NMN Sharpe, MSW, M.DIV., LISW-CP
• Travaisha Wenae Shaw, RPH
• Erin Mays Shealy, APRN, FNP

• Chiropractor in Irmo, SC
• Providers in Irmo, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.