Divine Life Health Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC4046 Issued in SC

Legal business name

DIVINE LIFE HEALTH CENTER LLC

Practice address

2200 Premier Resort Blvd Unit a
North Myrtle Beach, SC 29582-9203

Phone

(843) 877-1696

Fax

(843) 390-2379

NPI assigned

Feb 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Christine Mary Graham, DC

Title

Chiropractor

Phone

(843) 877-1696

Specialties & licenses 1

Addresses

Other names 1

• Essential Chiropractic LLC Former legal business name

Locations

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1306204623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PREMIER RESORT BLVD UNIT A",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295829203",
            "telephone_number": "843-907-3594",
            "fax_number": "843-390-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PREMIER RESORT BLVD UNIT A",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295829203",
            "telephone_number": "843-877-1696",
            "fax_number": "843-390-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE LIFE HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "843-877-1696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "DC4046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essential Chiropractic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Chiropractor in North Myrtle Beach, SC
• Providers in North Myrtle Beach, 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 15, 2018; 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.